fic: The Cuckoo -- Chapter 10
May. 15th, 2014 02:04 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
readingrat
Part II
Chapter 10: Treatment Plan
Wilson the friend was amusing; Wilson the oncologist was competent; Wilson the patient was a massive pain in the ass.
Pete couldn't fault Amy. She did her redoubtable best to draw Wilson into her web of neediness by insisting on keeping the child and making it clear that she wanted Wilson involved, to the point that Lisa, who had accompanied Wilson to New York to meet up with her ('No, Pete, you are not going. You'll say something terribly insensitive that'll make Amy run for the hills. I'll go with him to make sure he doesn't end the day in a bar!'), voiced her fear that Amy's sole aim in getting pregnant was to become Mrs Wilson IV.
"So?" Pete said.
"He's twenty-five years older than she is and he has been married three times already. She must be insane to consider him a desirable candidate for matrimony!"
"Maybe she isn't the sharpest knife in the drawer, but people who have unprotected sex generally aren't. Again, why should this bother us?"
"It's a recipe for disaster. Should we be encouraging this?" She bit her lower lip, as she always did when something made her moral compass spin wildly on its axis. "They'll be divorced in no time at all."
"If she doesn't reel him in, Wilson will be dead in no time at all. What's one more divorce in the greater scope of things?"
No matter what Amy's intentions were, her act should have sufficed to activate Wilson's innate protective instincts and make him agree to treatment, and it did – sort of. He agreed to get his medical state reassessed –- Lisa promptly bumped him to the top of the radiology waiting list at Philadelphia Central, so his scans were done in a matter of hours –- and to consult a specialist. Oh, and he tried to curb his drinking, for all that was worth. (Basically it meant that Pete wasn't allowed to bring any beer, let alone scotch, to Lisa's place so as not to 'tempt' Wilson, and that he was supposed to stop Wilson from sneaking out to bars when Lisa wasn't around.)
That was, unfortunately, the sum total of the concessions Wilson was prepared to make. Taking the specialist's (or anyone else's) advice was not part of his plan, as became apparent when he got back from the hospital.
"It's not going to be possible to perform a total resection," Wilson said, dumping his file on the coffee table when he returned from his consult with Philadelphia Central's head of oncology (who had been only too happy to fit Wilson into his tight schedule at no notice whatsoever when he heard that Wilson was not only a colleague of some renown, but also the interim dean's close friend). "I'd need several rounds of chemo to make resection a viable option at all, and even then, chances are that they won't get all of it, which means radiation afterwards. Statistically, thymic carcinoma patients don't show long-term benefit from subtotal resection or from adjuvant chemo or radiation. So, I'm better off not getting adjuvant treatment or surgery, because it won't improve my chances of surviving. It would merely keep me cooped up in hospital or at home, recovering from chemo or managing the side effects."
"Statistically thymic carcinoma patients may not benefit from partial resection or adjuvant treatment, but that doesn't mean you won't," Pete said. He scrunched up his face in thought. "What study is that and what was the sample size?"
Wilson didn't answer.
Pete pounced on the loophole. "Too small to be reliable, huh?"
Wilson folded his arms. "If I get treatment, I'll spend the next months praying to the porcelain god, and my immune system will be so compromised that hanging around an infant won't be an option. (That's assuming that I'll be fit enough to travel up to New York to see him.) Net result: months of suffering, separated from the kid I'm doing it all for, and in the end, I'll probably die anyway. No, I'm better off staying away from chemo and all the rest of it, and spending whatever time remains with my kid."
His logic was clearly faulty, but invoking the kid worked like a blinding spell on Lisa, whose resolve to bully Wilson into medical sense promptly crumbled. That had probably been Wilson's intention all along, and he reinforced the effect by adding a few more tear-jerk lines to the effect that he'd had a good life and that he'd die happy if he could only witness his brat's first few months.
"Fat lot of good that's going to do the kid!" Pete muttered when Wilson went off to phone Amy, presumably to get an update on her pregnancy. At Lisa's eye roll he elucidated, "Wilson may feel good about burping a little panty pooper who can't contradict him, but the kid won't remember him once he's dead. He'll leave no fucking trace in Mini-Jim's life other than those thick eyebrows that will get the poor schmuck teased all through school."
Lisa tugged a lock of hair out of her face. "The first months are crucial for a child's later sense of security and its ability to bond," she said.
"From which tabloid did you glean that piece of mumbo-jumbo?" Pete asked, knowing even as he did so that he'd regret challenging her over matters of parenting. Parents and religious nutters had no sense of proportion and very little critical reasoning.
"Rachel has always been, well, clingy, even before her accident. Her mother abandoned her right after she was born, and no one knows for how long she'd been alone before she was found. I think …,"
"I think, I believe, I am convinced. Those three verbs preface totally crappy science. Rachel," Pete said, unable to stop himself although disaster now lay at the tip of his tongue, "is clingy because you disappear for hours every day, when she wants you here with her."
"Are you saying I'm neglecting my kid?" Lisa asked, her voice rising.
"No, I'm saying that even kids have agendas."
"But you think she'd be happier if I were here with her when she comes home from school."
"Define 'happy'," Pete prevaricated, hoping to prevent a full-scale explosion.
"Don't evade! You're saying my child is unhappy because I'm not around enough!"
"That's not what I said," Pete defended himself, but Lisa hardly seemed to hear him. He'd badly underestimated her guilt about her long working hours and overestimated her confidence in her parenting abilities. Not his problem, he decided as he pitched himself into the fray. "Okay, she'd be happier if you were here all day. But she'd also be happier if you let her live off soda and candy."
"That's different," Lisa said. "Candy and soda lack nutrients and will rot her teeth. My presence here is not detrimental to her health, so if I make her unhappy by depriving her of it, then my behaviour is selfish."
How the hell had they got from Wilson's suicidal stupidity to Lisa's parenting skills?
"Does that mean I can have a soda?" a voice piped up from the doorway.
"Now what?" Lisa said, collapsing on the couch next to him after putting Rachel to bed.
"Nothing," he said, not taking his eyes from the TV screen as he stuffed a handful of chips into his mouth. How the hell had the Celtics managed to take the lead?
"You're gonna let him die?" she asked incredulously.
He deigned to turn towards her to look down his nose at her. "I thought you were all for respecting his wishes and letting him die a happy dad, freed from the responsibility of actually caring for the life he created."
"You were right, I was wrong, Wilson's being an idiot. Can we move on?" she said tersely, rolling her hand in illustration.
"We wait," he said, schooling his features into what he hoped was an expression of Zen patience.
"Wait?" she echoed him. "For what?"
"For him to consent to treatment."
"How exactly is scattering chips all over my couch going to make him do that?" she said, looking pointedly at the mess he was making.
He grabbed another large handful and crunched them with half-open mouth, scattering crumbs in a wide radius all around him. Lisa leaned over to pluck the bag from his hand and hold it out of his reach. He sighed.
"He's been on Zoloft again for ten days, and his mood's improving already. Another two or three days, and he'll be as reasonable as he's likely to get."
Her mood perked up immediately. "You got him to take his meds again?"
"Let's just say that I ensured that he takes them," he prevaricated. The enforced proximity of a road trip had one major advantage: they'd shared all meals, which had afforded him ample opportunity to slip Wilson's SSRIs into his over-sweetened morning coffee. If Wilson had been surprised at Pete's willingness to organise and pay for breakfast every morning, he hadn't shown it. The long hours spent out in the sun and the wind had done the rest – Wilson was considerably more upbeat than he'd been a fortnight ago.
Whatever comfort Lisa derived from his information suffered a set-back as the Celtics scored another two points against the Sixers, increasing their lead to a comfortable twelve points. "Three days, give or take, won't change him enough that he'll agree to a course of treatment that he considers hopeless at the moment," she said.
"It'll give me time to come up with an alternative," Pete said, switching channels. That game was going nowhere. "He doesn't want to run the marathon, so we'll have to find a 100-metre sprint he can enter for instead."
When Lisa looked at him blankly he huffed impatiently. "It'll have to be something that hits the tumour hard and fast, so he won't need several rounds of chemo before surgery."
"That's bound to be risky!"
"It can't get riskier than no treatment at all."
He spent the next few days emailing, phoning and cyber stalking the authors of the study that Wilson had cited, thanking his lucky stars that somewhere in his obscure past he'd learned Japanese, because their English wasn't exactly hot. They were scrupulously polite, they were sorry to hear that their colleague Dr Wilson was not well at all, they would be too happy to help in any way possible, but –- rescinding their findings and stating publicly that they'd made a huge mistake simply wasn't an option.
They could and did point him towards a number of clinical trials and alternative treatment options, and they sent him copies of every treatment regime they knew. He spent hours poring over medical journals, pharmaceutical reports and conference proceedings, open books and notebooks filled with jottings spread out around him. At night he'd sweep everything under the couch; in the morning he'd pull it all out again. It drove Lisa crazy, this encroachment on her living space, even though it had been her idea that he should stay at her place, right at the beginning when he'd come from the conference in Baltimore.
"You just want to lure me into your lair so you can have your wicked way with me when I'm drowsy and my defences are down!" he'd surmised only half jokingly as he'd scanned her face to read the true intention behind her unexpected offer.
She'd dealt up front with his suspicions. "Believe me, you're the last person I want camped in my apartment; your domestic skills leave much to be desired. But someone needs to keep an eye on Wilson when I'm at work, because otherwise he'll drink, and when he's drunk he's completely unreasonable."
The set-up had worked, sort of, before they'd left on their bike trip, probably because the knowledge that it was a temporary arrangement had made it endurable for Lisa. (Pete suspected that she made a notch in her bedpost for every day that she refrained from murdering him.) But now that he was there interminably, his belongings seeped insidiously into every corner of the apartment. Lisa had found his dirty laundry in Rachel's room, his porn DVDs stashed in the bathroom among her sanitary napkins (he'd thought it a fitting place – her underwear drawer, although more apt, had the disadvantage of not being accessible at night), and his beer hidden behind her books on interior design.
"Wilson will never find those cans; there's no way he'll look at wallpaper patterns and furniture," Pete pointed out, but Lisa, her eyebrows meeting her hair line, took the cans and disposed of the beer.
"You're right, he wouldn't pick any of those books for a bit of light reading," she said when he remonstrated loudly and vocally, "but he knows you well enough to figure out where you'd hide booze. There's a fifty percent chance at the very least that he'll find this lot."
His nightly perambulations through the apartment didn't help matters. Wilson and Rachel slept through it all in their respective rooms, Wilson not even waking up when he returned to the guest room in the early hours of the morning to lie down for a few hours on the trundle bed, but Lisa would pop out of her room like a jack-in-the-box whenever he went to the bathroom or into the kitchen (to raid the fridge) or out onto the small balcony off the kitchen for a smoke. It didn't take long till she had rings under her eyes that would have done a racoon proud.
"Do you have to prowl around all night?" she yelled at him when she caught him in the kitchen the third time within one night.
"I'm hungry!" he whined, scooping the last of Rachel's favourite chocolate chip ice-cream into his mouth.
Lisa frowned at the empty tub, but ignored the provocation. Instead she said, "Then take snacks with you into the living room, but: Stay. In. There!"
"How am I supposed to know in the evening what I'll want to eat at," he squinted at the kitchen clock, "three a.m.?" It was boredom rather than hunger that drove him, but she'd hardly appreciate the difference.
"Take a selection. I don't care. I need to sleep!"
"Use ear plugs."
"Then I won't hear Rachel if she needs help."
"For Chrissake, she's eight!" They were both yelling now.
"She's a cripple. At night, she's too disoriented to clamber into her wheelchair. If I don't assist her, she falls out of bed or gets stuck in the doorway."
"I can't sleep when you shout like that!" They whirled round to find Rachel glowering at them from the kitchen doorway. "And 'cripple' isn't a nice word to use. And," she added haughtily, turning her wheelchair to depart, "I can get into my wheelchair by myself whenever I want to!"
He broke the awkward silence by saying, "See? You don't need to play Martyr Mom for her."
Lisa strode out of the kitchen after Rachel, not even dignifying her exit with a parting shot.
Lisa phoned him the next day at lunchtime. "Wilson has agreed to see Nolan, and Nolan can fit him in this afternoon. Will you take him there?"
"Last I checked, Wilson had a valid licence and a car."
"Sessions with Nolan upset him. I don't want him alone afterwards while he processes."
Had she been corporeally present he'd have treated her to his brow-furrowed-in-earnest-contemplation look before shooting her down. The verbal version would have to suffice. "Hmm, let me see … Bit busy here –- there's a Columbo re-run in half an hour."
There were a few people in Europe whom he still had to contact, and daylight was fading fast there. Phoning them with Wilson sitting in the car next to him so as to discuss treatment options to which Wilson hadn't consented as yet didn't seem like a good plan. Besides, the drinking that Wilson was indulging in at the moment was controlled enough that it wouldn't affect his treatment (once he consented), and as long as that was the case he could drink for all that Pete cared. That was Wilson's life choice, not Pete's problem.
"Fine!" Lisa bit out at the other end. "I'll take him."
If she could make the time, why ask him in the first place? The answer came a moment later.
"Can you drop Rachel off at her friend's birthday party?" Aware of his reluctance she added, "You don't have to stay there or pick her up afterwards. I'll swing by with Wilson on our way back from Mayfield."
That shouldn't cost him more than half an hour, forty minutes max. "Okay. Where do I need to take her?"
"The invitation is pinned to the fridge. Address and telephone number are noted inside."
When Rachel got home from school he was trying to persuade a dim-witted German nurse to give him her boss's home number. "Ja, ich weiß, dass es in Deutschland nach Mitternacht ist, aber es ist … urgent … dringend!"
"Where's mom?" Rachel asked.
"Gone," he replied shortly. Rachel withdrew wordlessly to her room.
When he finally got hold of the person he wanted to talk to, a rather sleepy researcher in charge of a clinical study at the teaching hospital in Heidelberg, Rachel popped into the living room again.
"You can't watch TV now," he said without waiting to hear what she wanted.
"When's mom coming back?" she asked.
He glanced at the clock. "Six-ish. Now shut up!" He turned back to his phone call. "Octreotide? What dosage?"
"Who's taking me to Chiara's birthday?"
"And the prednisone? … What happens if one increases the dosage? … Okay. Can you send me treatment plans? … Have you tried combining cyclophosphamide or cisplatin with the prednisone? … Yes, I know it's risky. … Can you give me their phone number?"
Two phone calls and four emails later he finally remembered Rachel. By that time, according to the invitation, the birthday party had been under way for over two hours. Not worth the bother anymore, he decided, and phoned the Cancer Institute at Stanford University instead. Wilson would be happy to drive Rachel to all the birthday parties she wanted if he survived this.
Lisa was livid. "You said you'd take her!"
"I lied." He hadn't meant to –- he'd honestly meant to drop Rachel off at that insipid party of hers –- but his good intentions weren't worth the effort it took to voice them. For all the good it had done Rachel, he might as well have lied intentionally.
"Why? Why?"
He supposed he could tell her about his phone calls, but then, what difference did it make? So he shrugged with a show of indifference.
She threw her hands up. "If you'd just said you weren't going to do it, I'd have made other arrangements."
"Why didn't you? You know how I am."
"Because I was busy juggling two jobs and Wilson's appointment, and because I was benighted enough to believe that you could manage a simple domestic chore!"
That kindled his suspicions. "What, you dumped her on me to test my domesticity? To see whether I'd make a good dad for your orphan?" He glowered down at her. "I won't. I'm not the guy you're looking for."
A finger poked into his chest. "News flash, Gregory House! I wasn't looking for a mate for life. I was merely trying to keep things simple. I was hoping that I could ask a guy –- an adult –- who's living in my household and eating my food to do me a simple favour, instead of having to phone round friends, neighbours and babysitters to find someone who can do it at short notice!"
Her calling him 'House' was a sure sign that he'd gone too far. He scratched his eyebrow with his thumbnail. "She'll survive. Life is full of birthday parties we can't attend."
"This," Lisa hissed at him, "isn't about a stupid birthday party. This is about me telling Rachel she could go, and then she couldn't. She's holed up in her room crying her heart out, because she believes I didn't care enough to make it happen. Do you know how many parties she has to forgo or watch from the sidelines because the parents organise some 'fun activity' that Rachel can't participate in? Last year her 'best friend' went caving on her birthday, fricking caving! There was no way Rachel could go. And now, finally, there's a party that's 'wheelchair accessible', and you couldn't …"
"You're getting what I did (or didn't do) mixed up in your mind with the suckotage of her life as a cripple," he couldn't help pointing out. "Those are two completely different things."
She rubbed her forehead tiredly with the heel of her hand as she gazed at Rachel's closed door. "Maybe. Maybe they are for you. But they aren't for Rachel."
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no subject
Date: 2014-05-15 02:17 pm (UTC)no subject
Date: 2014-05-15 08:31 pm (UTC)The last one wasn't, but this one is also about Rachel, because what happens to Wilson and what goes on in her home affects her directly. (The show centred around House with the result that we got to see everything from his pov. We hardly ever got to see how devastating some of the things he did or said were for others and how his methods affected those who got caught in the maelstrom he invariably set off.) Life in the Cuddy household can't be pleasant for Rachel at the moment, but as House would say, if Wilson were to die, she'd be even worse off.
no subject
Date: 2014-05-15 10:54 pm (UTC)no subject
Date: 2014-05-16 12:25 pm (UTC)