readingrat | fic: The Cuckoo -- Chapter 7 (Reply)

Part II
Chapter 7: Confrontation and Consultation

It was a two hour drive back to Philly, which should have given her more than enough time to get herself sorted before she had to face Wilson, but the first half hour or so passed in a blur. She had crossed the Susquehanna and was approaching Wilmington before her brain would do anything but cough up disconnected facts on thymoma, such as the rate of incidence in the general population (which was neither here nor there, since Wilson had somehow managed to garner this rare species), progression (slow), survival rates (she didn't have those at her fingertips, but if she remembered correctly the prognosis was generally pretty good), and treatment (resection for the most part). She couldn't for the life of her remember whether adjuvant radiotherapy was indicated or what combination of drugs was recommended for chemo. Thymoma was simply too rare for its treatment to be a common subject of conversation in the doctors' lounge.

You're evading the issue, she scolded herself. Wilson will have all the facts at his fingertips, even if he's choosing to ignore them.

And that brought her back to the crux of the matter: Wilson. She hadn't been quite truthful with Pete regarding Wilson's absence tonight, partly out of consideration for his feelings and partly to avoid the repercussions for Wilson for as long as possible. For Wilson hadn't been too wasted to drive to Baltimore, although no one in their senses would have given him their car keys in view of his current propensity to end the evening in a bar. He had flatly refused to go collect Pete (or 'House', as Wilson had reverted to calling him) from the airport. Extrapolating from her past experience of their chequered relationship and his present intransigence, Cuddy had assumed that something or other that Pete had said or done had hurt Wilson to the point that he'd given up on their friendship. (Once again, she'd muttered to herself, grabbing her own car keys and rushing to drop Rachel off at the neighbour's place.) But past experience had also taught Cuddy that Wilson tended to snap out of his 'House peeves' sooner or later, and the less Pete knew about Wilson rejection, the easier it would be to glue the pieces together again. Pre-amnesia House had both needed and loved Wilson sufficiently to put up with the occasional roller coaster ride that Wilson had put both of them through, but Cuddy wasn't sure whether Pete felt that same irresistible tug towards his former friend. Even if he did, getting him to make overtures of peace would be an uphill battle. Far better to sit it out while limiting the damage they did to each other.

On the drive down to the airport she'd tried to figure out how to get the two men in her life close enough to each other that she'd be able to bash their heads together nice and hard. That was when she'd still believed that Wilson was sulking because Pete was neglecting him, a misconception to which Wilson had undoubtedly contributed his mite. When he'd toppled off the flight from London (escorted by a very pissed flight attendant) the only reason he'd given for his early return had been that Pete was too busy screwing willowy Irish psychologists to bother about him. It had sounded as though Pete had ignored him completely, leaving him to his own devices until he'd sought solace in alcohol and an early return. Oh, wily Wilson! She hadn't even suspected that the cause for Wilson's misery lay within himself.

She still wanted to bash their heads against something or other. Honestly, what was Wilson thinking, neglecting his thymoma for weeks? And surely Pete, as a former addict, knew better than to seek refuge in alcohol! But more than that, she wanted to scream out her rage at a deity in whose existence she hardly believed, and maybe she was gripping the steering wheel so hard because she'd like to clamp her hands around a certain psychologist's pale neck.

Screaming and raging, however, wasn't going to get her anywhere; she needed to prioritise.

Item 1 on the list: Pete's relationship problems.

There was nothing she could do about Pete's heartache except feel sorry for him, a sentiment that he'd resent, so it was best to file it away as a given. He'd get over it. ("Except, he never does," a Wilson-like voice noted.)

Item 2: his alcohol consumption.

It was worrying; he was in danger of sliding back into old patterns. But it would keep – he'd always been good at snapping out of downright harmful habits if some other distraction caught his attention. ("Except for the times he didn't snap out of them," the Wilson-voice reminded her, but she quickly shushed it.)

That left item 3: Wilson's cancer and the stand-off between Wilson and Pete.

Was Wilson ignoring his cancer because he felt neglected, or was he pushing Pete away because he wanted to be left in peace to deal with his illness as he pleased?

Let's not get ourselves involved in 'chicken or egg' debates, she told herself sternly. It didn't really matter which problem she tackled first; if she managed to solve one problem, the other would most likely dissolve into thin air. Getting those two divas to talk to each other could take months; knocking sense into Wilson's head shouldn't take more than a few minutes. That was, if they were talking of bog-standard stage I thymoma here. Five weeks was a long time, but thymoma wasn't a particularly aggressive cancer. Even if it took her another four or five weeks to talk Wilson into sense and sobriety, he'd be fine.

Or wouldn't he? There had been something in Pete's expression – dismay? panic? – that had been at odds with his casual 'stage I or II' diagnosis.

At her apartment block she walked past the elevator and headed straight for the stairs. She lived on the top floor, but since she always had to use the elevator when she was with Rachel, the tug in her leg muscles was satisfying rather than annoying. The apartment was dark and quiet when she came back, only a sliver of light under the kitchen door showing that Wilson was still up and waiting for her. She hung up her coat and slipped out of her shoes. Then she stood in the dark hallway tapping her teeth with her forefinger before squaring her shoulders and entering the kitchen. Wilson sat at the table, a mug in front of him, ostensibly leafing through the daily paper. He looked up as she came in, but she didn't say anything, merely walking over to the coffee machine, a long-ago gift of House's. She smiled as she remembered the impropriety of it: House had attempted to outwit karma by 'doing good'.

Wilson, lulled into a false sense of security by her reminiscent smile, asked off-handedly, "So, how is he?"

Cuddy placed a cup under the spout, pressed the button and waited for the grinding and whirring to cease before she turned to Wilson, leaning back against the counter as she gave him a measured glance. "Not so good: that woman of his left him."

Wilson digested this. "That's – unexpected."

"Really?" Cuddy asked abstractedly, her mind elsewhere. Had Wilson been drinking in her absence or had he managed to stay sober? He wasn't visibly drunk, but then, he'd gotten good at concealing all outward signs. She was glad she'd got Rachel to spend the night at Louisa's place; when Wilson lost control completely, he was a loose canon.

Wilson, blissfully oblivious of the fact that he and not Pete was up in the dock, rose to Pete's defence. "He isn't always an ass. He can be different. Not a conventional romantic, but attentive and considerate in his own way."

Cuddy placed her mug on the table and sat down opposite Wilson. "I'm aware of that," she said in measured tones, filing away for later contemplation the information that Wilson didn't expect her, Pete's previous girlfriend, to appreciate Pete's romantic potential. "I saw him with Stacy, remember?" She stirred her coffee, looking down into the swirling liquid. "He just couldn't be that way with me."

"Cuddy, that's not what I meant," Wilson protested, visibly distressed. "You – had to combine a work relationship with your private one. It was bound to lead to stress."

Cuddy patted his arm across the table. "Nice try, but I'm not an idiot. You don't need to try to make me feel better; I'm okay with it. I always knew I wasn't his first choice. I was the proverbial straw he was clutching at. That wasn't what split us up, anyway, and Pete's relationship skills aren't up for debate. He lost out to habit: the woman's husband came back."

"How's he coping?"

Cuddy watched Wilson surreptitiously as she stirred her coffee. If the question was a sign of genuine concern, then it meant that Wilson wasn't avoiding Pete because he'd given up on him, but because he wanted to sidestep Pete's peculiar brand of caring. Wilson was fidgeting, fingering the newspaper and creasing its edges, but there was no sign that the question was merely a polite phrase. She leaned forward, placing a soothing hand over his. "When were you planning on telling me about your thymoma?" she asked.

Wilson pinched the bridge of his nose with his free hand. "He told you."

"What did you expect?" Cuddy asked, raising an eyebrow.

"I dunno; some respect for patient confidentiality, maybe?" Wilson groused, but Cuddy could see his heart wasn't in it.

"You're his friend, not his patient," Cuddy said. Maybe Wilson needed to be reminded that he had a friend.

"He diagnosed me," Wilson said, echoing what Pete had said earlier. "That makes him my physician, I guess."

"So, what are you doing about it?" Cuddy asked casually.

"I got more scans done and a biopsy," Wilson said, looking down at the table.

"And?"

Wilson was silent for a moment. Then he said, "It's too big for a resection."

"So you'll be getting – what? Chemo? Radiation?" Cuddy asked. But she didn't need to wait for Wilson's answer; his expression, guilty and sad, said it all.

"It's thymic carcinoma," he said, adding by way of explanation, "the one that used to be called type C thymoma. The survival rate is nowhere near as good as for other thymomas. I'd need a combination of radiation and chemo to shrink the tumour, and chemo after the resection – that's if the tumour shrinks sufficiently to be operable – and there's no guarantee that it'll go into remission. I'm … not doing it."

"Why not?" Cuddy asked, genuinely puzzled. What Wilson had just described was rigorous for thymoma, but not at all uncommon for other types of cancer. "You're the oncologist; you know better than anyone else …"

"Exactly! I know better than anyone else what it means to go through several rounds of chemo, to be weakened and in utter misery, to spend your days in hospital puking and shivering, having to ask the nurses to change your soiled diapers because you can't make it to the bathroom anymore, to keep on fighting, and for what? In the end, it'll have bought me a few months, but it'll have been a few months of a non-life, time spent in sterile walls among people I don't know.

"I've seen it happen often enough, Cuddy. God forgive me, I've advised my own patients to take that course time and again, hoping I'd buy them some quality time, but as often as not I subjected them to weeks of futile suffering. I'm not doing it."

"But if it works?"

"What then?" Wilson said. "What do I gain?" And he looked at his hands.

She looked at them too. They were bare, not even a tan line remaining from his wedding rings. She got his meaning, but she was unwilling to concede his point. "Wilson, you know that Rachel and I love you and would miss you," she said gently.

"Cuddy, I'm an alcoholic with whom you can't leave your daughter for a single evening. Besides," he held up his hand to stop her protest, "you did fine without me for years. You'll do fine without me when I'm gone."

"And Pete?" Not exactly a trump card under the circumstances, but she had to try.

"House has his own life."

"He's alone again. And something's going on with his job. He wouldn't say anything about it, but I can make an educated guess based on his past employment history."

Wilson buried his face in his hands. From there he said in muffled tones, "Cuddy, I can't make life decisions based on the state of his love life or his work life. His life's a perpetual roller coaster ride, and I'm getting too old for the free fall phases and the loops. I'm getting off the ride."

Cuddy swallowed. "And if you don't get it treated?"

"Eight months, give or take." His calmness sounded rehearsed. It probably was.

A heavy silence hung in the air.

Cuddy changed tack. "You got scans and a biopsy done, so you've got an oncologist. Who are you seeing?"

Wilson avoided her eyes again. "I scheduled them myself." When Cuddy sat back letting out an exasperated breath, he said defensively, "I may not be practicing anymore, but I can still read scans and biopsy results. Based on those, the diagnosis and the prognosis won't change, no matter whom I consult. I've based my decision on facts that I am perfectly capable of interpreting. I don't need someone like me sweet-talking me into something I don't want to do!"

Cuddy rose and put away her cup. Then she contemplated Wilson, who was staring into space looking weary and miserable. Well, she could try to alleviate the misery, and it would buy her some time. "You're welcome to stay here for as long as you like, Wilson. If hospital isn't what you want, I'm sure we can engage a nurse or find a hospice."

"You accept my decision?"

"I can hardly drag you to chemo by your hair, can I?"

"What about Rachel? You don't want her to see me die."

She hadn't considered that. Okay, it would have to be a hospice – if she allowed things to get that far. But she hadn't done fighting yet; this was merely a strategic retreat. "We'll see when we get there," she said.

Wilson looked up, his eyes slightly damp. "Thanks, Lisa," he said as he rose. Then, at the door he turned and pointed a finger at her. "I know what you're planning: you think you can change my mind if you smother me with affection and surround me with family, but it won't work. I'm not changing my mind."

Cuddy waited until she heard the faucet in the bathroom, then she took out her cell and scrolled to Pete's number. It took a long time till he answered the phone, and when he did he sounded anything but happy. But he'd always been capable of snapping in and out of sleep and of functioning even when he was high and drunk, so she saw no reason to postpone this conversation.

"He hasn't had a resection," she said without any sort of prelude. "Nor is he getting chemo or radiation. He isn't doing anything about the damn tumour. It's thymic carcinoma, and he doesn't consider the survival rate high enough to bother with treatment."

There was relative silence at the other end; she could hear huffy breathing and creaking that signified that Pete was sitting up in bed. "Thymic carcinoma has a five-year survival rate of around 40%," Pete finally said. Trust him to have the figures at his fingertips even when he was jet-lagged and suffering from a hangover. "And this couldn't wait till tomorrow?"

"No, it couldn't, because although I've invited him to stay, he could be taking off for New York again any time, and then we won't be able to make him see sense," Cuddy snapped.

"'We'?"

"He is your patient."

"Technically, he wasn't even a patient. He was a 'case study'."

She played her trump card, the 'patient code'. House had felt bound by it to save his patients, no matter how great the personal inconvenience or the costs. "Your team diagnosed him, so that makes him your patient." Maybe not in a legal sense, but she knew how he worked. A patient was his until he passed him on to someone else (or the patient died). He didn't leave patients to fend for themselves.

She could hear him moving around and the gurgle of something being poured into a glass. She hoped it was water. "Well, he is diagnosed, isn't he, and he's an oncologist in his own right. He knows what to do. I don't have to take him by the hand and accompany him to his next appointment."

Good! He hadn't outright refuted the doctor-patient connection.

"He's drinking; he doesn't know what he's doing!"

"Then stop the drinking," Pete said.

"What the hell do you think I've been doing these past four weeks? I've been running interference with his boss to stop him from getting fired – although I guess that doesn't matter anymore – and trying to get him to see Nolan. Nolan says there's nothing he can do unless Wilson comes to him, and Wilson says there's nothing Nolan can do for him. … Oh, I guess Wilson means the thymoma," she said in sudden realisation.

"What meds is he taking?"

The change in topic caught her off guard. "Sorry?" Even if Wilson was on meds, how was she supposed to know what they were?

"Go check!" came the order from Baltimore.

"How am I ….?"

"Woman, that man is anal. If he's taking his meds, then he'll have them well within reach, either in your bathroom or in the guest room."

She stuck her head out of the kitchen. Wilson was still in the bathroom, so she scuttled into the guest room. She opened the drawer of the bedside table, but there was nothing there. She considered his suitcase, but he'd stowed it on top of the closet; she'd need to get a chair to reach it. Next she opened the closet. He'd put a few clothes there and hung up two shirts – enough to get him through the weekend. On one of the shelves he'd placed a bag with a few toiletry articles. And in it was a pill bottle, orange like the ones she'd so often seen House handle. She took it and hurried back to the kitchen, where she closed the door.

"Got it," she said into the phone. "Zoloft."

"Dosage, date of refill, number of pills left?" Pete queried routinely.

Cuddy squinted at the label. "100 mg, about twenty of the fifty pills left, refilled on – oh!"

"Lemme guess: Jimmy hasn't been taking his meds?"

Cuddy did a quick calculation. "Not since he returned from England," she said.

Little explosive pops came from the phone. Cuddy had no idea what they were, but chances were that they were caused by Pete's thinking process.

"Let's say he forgot his meds because he was drunk. He had withdrawal symptoms, didn't recognise them as such (because he was drunk), and self-medicated with more alcohol. Or he decided to do the responsible thing and not mix SSRIs with alcohol," Pete mused aloud.

Cuddy snorted.

Pete clicked his tongue. "Or maybe the combination of alcohol and Zoloft makes him feel funny in a not-so-good way, so he tells himself every day, 'Tomorrow I'll stop drinking and then I'll take my meds again,' but tomorrow never comes."

"Thing is," Pete continued, "when you stop taking your SSRIs against the doctor's advice, it doesn't improve your outlook on life. Makes everything seem bleak and hopeless, especially cancer treatment. Gotta get him back on the meds."

"So it boils down to his quitting the booze," Cuddy said with a sinking feeling. She couldn't help remembering how long his previous stay in Mayfield had been. How long would it take for Wilson to feel well enough to take his fate into his own hands again?

Pete practically echoed her thoughts. "If he's got the time for that. I need his scans, recent scans," he demanded.

"I'm sure he has a set in his suitcase," Cuddy said sarcastically.

"They'll be in his medical records, and those are bound to be stored in digital format on some hospital server or other, depending on where he got them done."

"Well, I haven't got access to those either."

"Has he brought a laptop?"

"Yes, but … Pete, I can't even hack into Rachel's account when she forgets her password, much less into Wilson's. Wilson may not be a computer nerd, but in the years with you he learned to protect all his accounts."

There was silence at the other end. Doubtless Pete's former team would have done a better job than she could do. Foreman or Thirteen, hardened by years of getting 'detailed patient histories', as they had called their snooping and spying, would have made short shrift of Wilson's security measures.

"Okay, I'm coming the day after tomorrow." With that the line went dead.