fic: The Price of Healing — Chapter 2/5
Oct. 8th, 2016 05:01 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
readingratChapter 2
Next day Wilson wasn’t at work. Cuddy said something vague about ‘a personal day'; Wilson’s assistant didn’t know anything at all other than that he’d had to cancel all appointments for the day.
“Does he do that often?”
“Do what often?” the assistant asked.
“Take sudden personal days?”
“Oh, this wasn’t sudden. He told me three days ago to stop taking new appointments for the day and to look for possibilities to shift the ones he had already. In fact, I was supposed to clear two days because he wasn’t sure yet which one he’d need.”
So much for sudden-onset flu. Wilson had known he’d crash and he’d known roughly when it would happen. Other than flu, what could have caused Wilson’s symptoms? House ransacked Wilson’s office, but found nothing that indicated chronic pain, autoimmune diseases, obscure genetic disorders, drug abuse, addiction, mental issues (if you ignored the trophies and teddy bears on his shelves and the posters decorating the walls), etc. Next House hacked Wilson’s medical file, but there too nothing explained a predictable health-induced absence. Wilson’s health slate was squeaky-clean.
Julie attributed Wilson’s present state to his patient’s recovery. That made no sense whatsoever, but Julie wasn’t exactly an idiot. House pulled the patient file and spent the afternoon studying it while he kept his team busy running useless tests on their own patient. Thirty-two year old Caucasian female with metastatic breast cancer that had gone into remission three years ago, only to return two years later in her bones and brain. Chemo, hormones, and radiation hadn’t worked, and after a series of seizures she’d been admitted to the hospital. Wilson’s staff had noted each and every symptom meticulously: confusion, loss of bladder control, fluid build-up in the lungs, loss of consciousness. The woman had been dying.
And then, three days ago, the first signs of improvement. Her breathing eased, the fluid build-up receded, and the patient regained consciousness. Brain scans carried out a day ago showed no signs of a tumour.
Wait, what?
House examined the previous brain scans again. And then the bone scans. The latest ones weren’t entirely conclusive, but at a stretch House would say that her bones were on the mend.
Next he went to the oncology ward to look at the patient. She was sitting up in her bed, looking wan but happy, surrounded by family — a man and three children roughly between two and eight years old. House hobbled into the nearest doctors’ lounge, snagged a lab coat that was hanging on a rack (it was way too small), and returned to the room.
“Hello, I’m Dr Greg House. Dr Wilson asked me to drop by and see how you’re doing.”
“He’s too good,” the woman said, giving House a warm smile. “He spent the entire night with me, and half the day yesterday, and he still can’t stop caring, can he?”
“Where is he?” the husband asked, aggression masking his worry. “Don’t get me wrong, he did a great job, but they told us before that the cancer was gone, and then it came back.”
“Did he say it was in remission now?” House asked casually, feeling the patient’s pulse. Its beat was strong and regular, her eyes were clear, her skin was pale but moist. She looked very much alive. Weary, but nowhere near death’s door.
“Yes, he did. Yesterday,” the husband said. “Isn’t it?”
“He said I showed no evidence of disease,” the woman said. Turning to her husband she said, “He wouldn’t lie, Jeff.”
“Everyone can make a mistake,” Jeff said, not quite meeting her eyes.
“People lie, but the scans don’t,” House said. “The brain scan is clear. So is the bone scan. I can do another one, though, if you like.”
“No,” the patient said.
“Yes!” her husband said.
“Scan, it is. I’ll schedule you for this afternoon,” House said. He rose and left the room. The man, Jeff followed him out, catching up with him at the elevator.
“Dr House! Look, I don’t want to seem ungrateful or anything —“
“You are,” House tried to cut him off, but the man refused to be cowed.
“— but I’m confused, here. Three years ago they told us that Gillian was cured. Then the cancer returned; okay, we knew that could happen. We went through hell to keep her alive, but a week ago they told us that . . . that there wasn’t much of a chance and if there was anyone she wanted to see before she went . . . Anyway, so I called her mom and her brother, and the kids said goodbye . . .”
“Your point?” House asked, wishing the elevator would arrive.
“My point is that if this is a temporary thing, I need to know. I can’t keep putting my kids through this. I can’t get their hopes up only to tell them they need to say goodbye again.”
House bounced his cane a couple of times, building up a rhythm to accompany his words. “Remission in metastatic breast cancer is by definition a temporary thing. So if you’re talking about the next ten years, I can’t reassure you. If you’re talking about the next months, you can rest easy.”
“Then why’d everyone tell us she was dying?”
“Because she was. She isn’t now. Be grateful.”
“That isn’t an explanation!”
“No. And it makes me unhappy, but it shouldn’t bother you.”
The afternoon scans confirmed the ones of the previous day. The woman had, for all intents and purposes, no visible symptoms or manifestations of cancer. House pored over the sets of scans, tapping a pencil against his teeth. How had that happened and what was the connection to Wilson’s ‘flu’?
The next morning his team stared at the whiteboard in disbelief.
“Our patient has cancer now?” Chase asked, rubbing his eyes.
“Would you still have a job if he had cancer and you’d neglected to mention this in his patient history?” House countered. “This is Wilson’s patient.”
Cameron’s expression cleared as she stepped up to the whiteboard. “Wilson asked for a consult?”
“Sort of,” House said. This case was screaming for a consult and House was happy to oblige before Wilson even asked for it.
Foreman flicked through the patient file. “House, there’s no mystery here. This patient has cancer, metastatic breast cancer. It sucks, but there’s nothing we, or Wilson, can do. Let’s get back to our patient.”
“Apparently there was something Wilson could do, because the woman is on the verge of being released with no evidence of disease.”
“You’re kidding!” Foreman said.
“Here’s the last page of that file,” House said, pulling the paper out from under a pile of journals dealing with the latest treatment methods for aggressive cancers.
Chase, sitting closest to House, took it and glanced at it. “Looks like she’s out of danger for the moment. And we’re bothering about a patient who isn’t dying or showing inexplicable symptoms, because . . .?”
House gave Chase a ‘duh’ look. “A woman who was riddled with metastases a week ago is in remission as of now. That kinda fits my definition of ‘inexplicable’.”
“Maybe the treatment worked,” Foreman suggested, leaning back to indicate total disengagement.
“Even if the treatment worked,” Cameron said slowly, comparing two scans, “the tumours couldn’t have shrunk that quickly. Maybe radiology messed up and the scans got swapped.”
House nodded. “How can we verify or exclude that possibility?”
Chase took the scans of the patient’s head and held them up to the light. “Nah, it’s the same patient. Look at the teeth: the chipped left incisor and the two molars with root work.”
Foreman held the scans of the spine up to the light in turn, tossing them down in confirmation a moment later.
House released the air in his mouth with a plop. “Okay, so it’s the same patient. Any other ideas?”
Chase pushed the scans back and forth in front of him like cards in a card trick. “Perhaps,” he said cautiously, “there is no logical explanation.”
House whirled around and thumped the table with his fist. “There’s always an explanation!” he roared. “And I intend to find it.”
Foreman sighed. “House, how about concentrating on the patient who’s dying instead of the one who’s gonna live? She can wait; our patient can’t.”
“He’s right, House,” Cameron said. “Let’s be happy that Wilson managed to save this woman. Now about Bradley: are there any new symptoms?”
Wilson returned to work a day later, pale but with no other signs of the flu or any other ailment. When House quizzed him about his patient’s meteoric recovery he threw his hands up defensively.
“House, I have no idea why she went into remission. It’s just one of those things that happen when you’re dealing with cancer. But I’m not about to complain: it’s rare enough that my patients manage to thumb their noses at death.”
“And your collapse? Julie said —“
“Julie,” Wilson said carefully, “ascribes a lot of my failings to my profession because it spares her the bother of looking too closely at our relationship.”
“You’re saying you crashed because of your marriage?” House enquired, not knowing whether to be amused or seriously concerned about Wilson’s mental health.
“I had a weak spell because I worked too hard and slept too little in the days before Gillian went into remission.”
“And that had nothing to do with her cancer and everything with the state of your marriage,” House said skeptically.
“Of course it had something to do with Gillian; I spent hours at her bedside making sure she was comfortable and —“
“And holding her hand.”
“And holding her hand,” Wilson confirmed. “I do it because I want to, not because my job obliges me to. Perhaps the hours in Gillian’s room drained me, but if she’d died and I hadn’t been there, I’d have been in a worse state. But Julie doesn’t want to see that I’m not the nine-to-five guy she thought she’d married. She blames it on the job when it’s all me.”
It was rare that Wilson talked about his marriage. Normally House’s insights into his friend’s matrimonial problems were restricted to what he could observe or deduce, so he was pleasantly surprised to be the recipient of one of Wilson’s rare confidences. (It only struck him much, much later that Wilson had said very little about his patient’s surprising recovery.)
Unfortunately (or predictably, as Foreman would say), before House had a chance to follow up on Wilson’s miraculously cured patient, his own patient took a turn for the worse. The next month was spent in a flurry of tests, scans, treatment options, searches for donor organs, organ transplants, consultations with the hospital’s lawyers, court appearances, and those many unpleasantnesses that occur when one supersedes a patient’s wishes to save his life instead of letting him die of his own stupidity. The Case of the Inexplicable Remission still nagged at House occasionally, but not with immediate urgency. Since Wilson appeared normal again and his own patients took up his attention, he let the matter slide.
Next day Wilson wasn’t at work. Cuddy said something vague about ‘a personal day'; Wilson’s assistant didn’t know anything at all other than that he’d had to cancel all appointments for the day.
“Does he do that often?”
“Do what often?” the assistant asked.
“Take sudden personal days?”
“Oh, this wasn’t sudden. He told me three days ago to stop taking new appointments for the day and to look for possibilities to shift the ones he had already. In fact, I was supposed to clear two days because he wasn’t sure yet which one he’d need.”
So much for sudden-onset flu. Wilson had known he’d crash and he’d known roughly when it would happen. Other than flu, what could have caused Wilson’s symptoms? House ransacked Wilson’s office, but found nothing that indicated chronic pain, autoimmune diseases, obscure genetic disorders, drug abuse, addiction, mental issues (if you ignored the trophies and teddy bears on his shelves and the posters decorating the walls), etc. Next House hacked Wilson’s medical file, but there too nothing explained a predictable health-induced absence. Wilson’s health slate was squeaky-clean.
Julie attributed Wilson’s present state to his patient’s recovery. That made no sense whatsoever, but Julie wasn’t exactly an idiot. House pulled the patient file and spent the afternoon studying it while he kept his team busy running useless tests on their own patient. Thirty-two year old Caucasian female with metastatic breast cancer that had gone into remission three years ago, only to return two years later in her bones and brain. Chemo, hormones, and radiation hadn’t worked, and after a series of seizures she’d been admitted to the hospital. Wilson’s staff had noted each and every symptom meticulously: confusion, loss of bladder control, fluid build-up in the lungs, loss of consciousness. The woman had been dying.
And then, three days ago, the first signs of improvement. Her breathing eased, the fluid build-up receded, and the patient regained consciousness. Brain scans carried out a day ago showed no signs of a tumour.
Wait, what?
House examined the previous brain scans again. And then the bone scans. The latest ones weren’t entirely conclusive, but at a stretch House would say that her bones were on the mend.
Next he went to the oncology ward to look at the patient. She was sitting up in her bed, looking wan but happy, surrounded by family — a man and three children roughly between two and eight years old. House hobbled into the nearest doctors’ lounge, snagged a lab coat that was hanging on a rack (it was way too small), and returned to the room.
“Hello, I’m Dr Greg House. Dr Wilson asked me to drop by and see how you’re doing.”
“He’s too good,” the woman said, giving House a warm smile. “He spent the entire night with me, and half the day yesterday, and he still can’t stop caring, can he?”
“Where is he?” the husband asked, aggression masking his worry. “Don’t get me wrong, he did a great job, but they told us before that the cancer was gone, and then it came back.”
“Did he say it was in remission now?” House asked casually, feeling the patient’s pulse. Its beat was strong and regular, her eyes were clear, her skin was pale but moist. She looked very much alive. Weary, but nowhere near death’s door.
“Yes, he did. Yesterday,” the husband said. “Isn’t it?”
“He said I showed no evidence of disease,” the woman said. Turning to her husband she said, “He wouldn’t lie, Jeff.”
“Everyone can make a mistake,” Jeff said, not quite meeting her eyes.
“People lie, but the scans don’t,” House said. “The brain scan is clear. So is the bone scan. I can do another one, though, if you like.”
“No,” the patient said.
“Yes!” her husband said.
“Scan, it is. I’ll schedule you for this afternoon,” House said. He rose and left the room. The man, Jeff followed him out, catching up with him at the elevator.
“Dr House! Look, I don’t want to seem ungrateful or anything —“
“You are,” House tried to cut him off, but the man refused to be cowed.
“— but I’m confused, here. Three years ago they told us that Gillian was cured. Then the cancer returned; okay, we knew that could happen. We went through hell to keep her alive, but a week ago they told us that . . . that there wasn’t much of a chance and if there was anyone she wanted to see before she went . . . Anyway, so I called her mom and her brother, and the kids said goodbye . . .”
“Your point?” House asked, wishing the elevator would arrive.
“My point is that if this is a temporary thing, I need to know. I can’t keep putting my kids through this. I can’t get their hopes up only to tell them they need to say goodbye again.”
House bounced his cane a couple of times, building up a rhythm to accompany his words. “Remission in metastatic breast cancer is by definition a temporary thing. So if you’re talking about the next ten years, I can’t reassure you. If you’re talking about the next months, you can rest easy.”
“Then why’d everyone tell us she was dying?”
“Because she was. She isn’t now. Be grateful.”
“That isn’t an explanation!”
“No. And it makes me unhappy, but it shouldn’t bother you.”
The afternoon scans confirmed the ones of the previous day. The woman had, for all intents and purposes, no visible symptoms or manifestations of cancer. House pored over the sets of scans, tapping a pencil against his teeth. How had that happened and what was the connection to Wilson’s ‘flu’?
The next morning his team stared at the whiteboard in disbelief.
“Our patient has cancer now?” Chase asked, rubbing his eyes.
“Would you still have a job if he had cancer and you’d neglected to mention this in his patient history?” House countered. “This is Wilson’s patient.”
Cameron’s expression cleared as she stepped up to the whiteboard. “Wilson asked for a consult?”
“Sort of,” House said. This case was screaming for a consult and House was happy to oblige before Wilson even asked for it.
Foreman flicked through the patient file. “House, there’s no mystery here. This patient has cancer, metastatic breast cancer. It sucks, but there’s nothing we, or Wilson, can do. Let’s get back to our patient.”
“Apparently there was something Wilson could do, because the woman is on the verge of being released with no evidence of disease.”
“You’re kidding!” Foreman said.
“Here’s the last page of that file,” House said, pulling the paper out from under a pile of journals dealing with the latest treatment methods for aggressive cancers.
Chase, sitting closest to House, took it and glanced at it. “Looks like she’s out of danger for the moment. And we’re bothering about a patient who isn’t dying or showing inexplicable symptoms, because . . .?”
House gave Chase a ‘duh’ look. “A woman who was riddled with metastases a week ago is in remission as of now. That kinda fits my definition of ‘inexplicable’.”
“Maybe the treatment worked,” Foreman suggested, leaning back to indicate total disengagement.
“Even if the treatment worked,” Cameron said slowly, comparing two scans, “the tumours couldn’t have shrunk that quickly. Maybe radiology messed up and the scans got swapped.”
House nodded. “How can we verify or exclude that possibility?”
Chase took the scans of the patient’s head and held them up to the light. “Nah, it’s the same patient. Look at the teeth: the chipped left incisor and the two molars with root work.”
Foreman held the scans of the spine up to the light in turn, tossing them down in confirmation a moment later.
House released the air in his mouth with a plop. “Okay, so it’s the same patient. Any other ideas?”
Chase pushed the scans back and forth in front of him like cards in a card trick. “Perhaps,” he said cautiously, “there is no logical explanation.”
House whirled around and thumped the table with his fist. “There’s always an explanation!” he roared. “And I intend to find it.”
Foreman sighed. “House, how about concentrating on the patient who’s dying instead of the one who’s gonna live? She can wait; our patient can’t.”
“He’s right, House,” Cameron said. “Let’s be happy that Wilson managed to save this woman. Now about Bradley: are there any new symptoms?”
Wilson returned to work a day later, pale but with no other signs of the flu or any other ailment. When House quizzed him about his patient’s meteoric recovery he threw his hands up defensively.
“House, I have no idea why she went into remission. It’s just one of those things that happen when you’re dealing with cancer. But I’m not about to complain: it’s rare enough that my patients manage to thumb their noses at death.”
“And your collapse? Julie said —“
“Julie,” Wilson said carefully, “ascribes a lot of my failings to my profession because it spares her the bother of looking too closely at our relationship.”
“You’re saying you crashed because of your marriage?” House enquired, not knowing whether to be amused or seriously concerned about Wilson’s mental health.
“I had a weak spell because I worked too hard and slept too little in the days before Gillian went into remission.”
“And that had nothing to do with her cancer and everything with the state of your marriage,” House said skeptically.
“Of course it had something to do with Gillian; I spent hours at her bedside making sure she was comfortable and —“
“And holding her hand.”
“And holding her hand,” Wilson confirmed. “I do it because I want to, not because my job obliges me to. Perhaps the hours in Gillian’s room drained me, but if she’d died and I hadn’t been there, I’d have been in a worse state. But Julie doesn’t want to see that I’m not the nine-to-five guy she thought she’d married. She blames it on the job when it’s all me.”
It was rare that Wilson talked about his marriage. Normally House’s insights into his friend’s matrimonial problems were restricted to what he could observe or deduce, so he was pleasantly surprised to be the recipient of one of Wilson’s rare confidences. (It only struck him much, much later that Wilson had said very little about his patient’s surprising recovery.)
Unfortunately (or predictably, as Foreman would say), before House had a chance to follow up on Wilson’s miraculously cured patient, his own patient took a turn for the worse. The next month was spent in a flurry of tests, scans, treatment options, searches for donor organs, organ transplants, consultations with the hospital’s lawyers, court appearances, and those many unpleasantnesses that occur when one supersedes a patient’s wishes to save his life instead of letting him die of his own stupidity. The Case of the Inexplicable Remission still nagged at House occasionally, but not with immediate urgency. Since Wilson appeared normal again and his own patients took up his attention, he let the matter slide.
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