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System Failure: Part Three
by phineyj and snarkbait
Chapter 6: Foreman
"He doesn't take drugs," the singer assures me.
I don't believe him.
I don't know if that's because working for House has made me as cynical as him, or because this guy looks like he's just smoked half a pound of weed.
Those documentaries you see on the TV; the ones which take you inside rock star tour buses.
That is not what this place looks like.
It's a mess; beer cans all over the floor, unwashed and un-ironed clothes everywhere.
And it smells like four grown men have been living in here over the past few weeks.
I gaze at the bong sitting in front of the guy, and raise an eyebrow.
`That's for Dennis; I don't class Dennis as drugs," he says.
"What's Dennis?" I ask.
He looks wasted. His eyes slide to the side in thought and his mouth falls open; eventually he answers. I can tell he's having a hard time focusing on me.
"It's what you yanks call pot," he says, and then lets out a rattling cough.
I figured, but you have to check.
"So he smokes pot, which means he does do drugs," I reply.
The guy shakes his head. "You're wrong, mate. I smoke pot; Sam can't, because of his asthma. He won't let us smoke it in here half the time in case it sets him off. And his wife doesn't approve, either," he informs me.
I sense some negativity toward Cathy straight away.
I tap a can away from my foot as I reach over and have a proper look at the bong.
It looks well used. I give it a sniff; smells like pot. I don't think it's used for anything else.
I place it back down in front of the guy.
"You want me to set one up, mate?" the singer says, grinning.
"I think I'll pass, thanks," I return.
"Suit yourself," he replies.
"Who else was in the crash, in Bolivia?" I ask him.
"No one; Sam and Cathy did that alone. The rest of us went to Hawaii. Who wants to go to fucking Bolivia?" he says distastefully, shaking his head.
"Sam used to party, you know, with the band. Now he's married, it's all about the music, and the rainforests," he giggles lightly. "Thinks he's fucking Sting or something, ever since he met Cathy."
"Don't you like Cathy?" I ask.
"Sure I like her; she's nice enough. She's just turned my best mate into a preppy little shit, that's all, but it's half his fault for being so easily pussy whipped, so I can't blame her completely."
"Maybe he loves her?" I suggest.
The guy laughs, like I cracked a joke.
"Yeah, maybe he does, but Sam's loved a lot of girls since we started this thing; he just never married any of them before."
I nod. Arguing about the guy's best friend is going to serve no medical purpose.
"Did Sam use to take drugs, before he met Cathy?" I ask.
"He did E, now and again, but nothing else. Sam's thing was always beer. When he had his drinking hat on, he could drink us all under the table," he says, proudly.
"You say, `had always been'; he doesn't drink any more?" I reply.
I really would like to get the hell out of here now; it reeks.
He gets a sheepish look on his face.
"Sam, he's a nice guy, but once he starts drinking he can't stop, and once he's had too much, he can get a bit violent."
"Oh, so she stopped him from drinking," I say; sounds like the right course of action if you can't handle your liquor.
He nods.
"She saw him in a hell of a state one night," the guy laughs; he seems genuinely tickled by the memory.
"He kicked off on Danny, one of the roadies," he laughs some more "Danny shit himself, but Cathy saw him, she was - scared. She said if she saw him like that again, she would leave him. I guess he believed her," he says. He seems unconvinced of Cathy's threat.
"You don't think she'd leave him?" I ask.
"He's a rock star; what bitch leaves a rock star? Of course she wouldn't," he replies.
Gee, that's not cynical; House would love this guy.
He leans forward, and lights his bong, lighting the pot in the bottom then tugging on the pipe with his lips until he's coughing out a lungful of thick grey smoke.
"Did they seem okay, when they got back from Bolivia; any complaints of a poorly tummy, of anything?" I ask.
"Sam had tummy pain before he went to Bolivia; he practically stopped eating. She probably told him he looked fat, and now he's gone fuckin' anorexic or something," the guy says, then takes a hit from his bong again.
"How long has he been off his food, then?" I ask; I really need to get out of here, before the smell of that pot clings to my clothes.
Too much fuel for House's fire, if he smells it on me.
"Almost two months; said he felt sick when he ate. He's a girly little fucker sometimes, he likes to look good, and it's hard looking good all the time when you're in the public eye. I thought he was just trying to trim down."
"Okay, well I should probably get back now. Thanks for letting me look around," I finish, politely.
I'm almost at the door; almost outside in the fresh air, when he says.
"Is he gonna be alright like?"
I turn around; the guy finally looks like he cares, like his best friend is laid up in a hospital ward.
"I don't know; we need to know what's causing the stomach pain. But there are still a lot of tests we have to run. You should probably go see him,"
The guy nods, but I can tell he won't.
He must really hate his friend's wife.
Chapter 7: House
I'm watching TV in the oncology lounge, when I receive a page from Cameron, letting me know our patient has just crashed.
The tests we had back earlier ruled out ulcer and heart attack, so this is obviously something new.
One phone call later and I consider myself fully informed.
And I'm not happy.
Cuddy was the one who stabilized the Coyote.
Which leads me to a very important question; why the hell was Cuddy with my patient?
I abandon my show, and head up to the office. Cameron, Chase and Foreman are standing waiting for me when I arrive.
"Update," I say, briskly.
I find a short delivery from me usually encourages the information I need from them, without the bells and whistles of bullshit they usually dress their words with.
"Sam's condition is getting much worse. He passed out again when Cuddy was..."
"When Cuddy was what? What was she doing there?" I snap, butting in on what Cameron is saying.
I don't like or want Cuddy near my patients. She's like a bad luck charm whenever she goes near one.
"I don't know why Dr Cuddy was there; taking an interest in the famous patient she's been fielding calls about, perhaps," Cameron suggests sternly, and I back down.
That's probably true. But I still don't like it.
Cameron is probably still on a high, because she was right about the drugs.
This also displeases me greatly, but it only means Cameron one, me ten thousand in the grand scheme of things, so I'm not going to let it worry me too much.
"Sam is stable, but we need to find out what's going on in there soon," she says, toning down the gloat she's been riding on from his angelic tox screen; obviously she's just remembered there is a sick, hot, rock star that needs to be fixed.
"I've also just got the parasite tests back; they reveal nothing conclusive," she says, aiming to hand me the results.
I ignore her gesture, and head to the coffee machine to make myself a drink. It tastes like cold mud, but I need a caffeine hit.
"Maybe he's going into cardiogenic shock," Chase suggests, wildly.
I turn and focus a displeased look on him for that effort. Luckily, Foreman seems to be getting as bored as me and steps in before I tear Chase a new one.
"Primarily caused by failure of the heart; you said yourself earlier that the echocardiogram revealed no heart problems," Foreman raises his eyebrows and fixes Chase with a stern stare.
This is so much easier when I can sit back and let them do all the work.
"I did a serum enzyme test while I was waiting for the parasite results to come back; it's normal. It's definitely not his heart," says Cameron.
"A normal serum enzyme test would also suggest this isn't an infection," Foreman adds.
Undeterred by his previously stupid statement, Chase has another stab at making a hash of the diagnosis.
"What if he picked up a minor injury in the crash in Bolivia that he never got treated; pericardial fluid could have been leaking into the heart..." he begins.
"It's not his heart," I snap, and move towards the whiteboard.
Foreman picks up Chase's echocardiogram result and looks at it.
"There is no evidence here of fluid around the heart. Size, shape and motion of the heart is normal," he comments.
"Okay; what if the injury was chest based, fluid could be leaking into his lungs, causing his breathing problems, and his body would be starved of oxygen, causing all sorts of damage," Chase counters.
"He isn't hypoxic, and that wouldn't explain the increasingly worsening stomach pain," Cameron tells Chase.
Who finally seems to give up.
"He is a little anemic, though," Cameron adds, turning to me.
"He a veggie?" I ask.
Cameron shrugs.
"Find out," I say, and then glare at Chase. "That should be on the patient history," I tell him.
We need to find out what's going on inside Sam's gut; anemia is the least of his problems, unless it's connected to everything else.
I add it to the board.
"His band mate mentioned that he was off his food before the trip to Bolivia, that could mean whatever has been causing the stomach pain has been around a lot longer than what we first thought," Foreman says.
"True, it could also mean he's in a rock band, and he's not eating, because I hear that's all the rage when you're swimming in famous circles," I suggest.
Foreman folds his arms and gives me one of his stern looks. Ooh that's a new one; I don't think I've seen it before. He must have been practicing that one in the mirror.
I roll my eyes, but add `lack of appetite' to the board anyway - it could be connected.
"Peritonitis would cause severe lower abdominal discomfort," I suggest, even though it wouldn't account for all of the symptoms.
"He doesn't have any swelling around his abdomen," Chase counters stoutly.
Kiss my ass Chase; you've been throwing out a line of crap since I came in here.
"But he does have a very tender stomach, or did I just imagine that symptom? We need a laparoscopy," I return.
Chase places his hands on his hips and then tips his chin upwards.
"What if he got cholera or dysentery while he was out in Bolivia; he could have gastroenteritis; that would give his stomach hell," Chase suggests.
"If he had cholera or dysentery, he'd have diarrhoea coming out of his ears, not constipation," I return.
"Not if there was a blockage," Chase replies. "But what there would be is intense abdominal pain."
He says it arrogantly enough to know he could be right. It's true, and way more likely than peritonitis. Now I know why I keep the little shit around.
"Throw in a liver biopsy then, whilst you're poking around," I say dismissively.
"The guy at the bus also mentioned Sam used to drink quite heavily; it seems unlikely in a patient so young, but if the problem was severe and he's still drinking, despite saying he's not, he could have cirrhosis of the liver," Foreman says.
Obviously his memory has been jarred by the mention of the biopsy.
"The liver biopsy will tell us if he's still drinking," I'm about to chew Foreman out for not mentioning this earlier when, lo and behold, Cuddy enters the room.
"What's going on," she demands.
That's neither a question nor a statement, so she's not having a polite answer.
"Don't worry," I say dramatically. "No one's having any fun, so you don't have to come and piss on any bonfires. I'll let you know if Cameron cracks a smile though," I say.
Cameron and Cuddy exchange a mutual `House is such an ass' look.
It's very girl power. I'm surprised one of them doesn't whip a hand from side to side and say `Ignore him, girlfriend.' And then click their fingers.
"The kid crashed down there, and he's in a bad way. Now I want to know what your thoughts are," Cuddy says, sternly.
She just loves playing school principal.
"I want to know why you want to know," I reply, the tone of my voice dripping with curiosity.
I also want her to know that I'm on to something, to put her on the back foot.
"Because this is my hospital, and I'm getting twenty calls an hour, enquiring about Sam's condition," Cuddy replies, but there is something in her eyes that is warning me to back off a little.
Red rag to a bull, Cuddy, you idiot.
And why is she suddenly unable to lie? That was a shitty lie.
For some reason this all leads me to wonder who David is again. I make sure I don't divert my eyes from her until she looks away first.
"This could also be multiple system failure; we should do a HIV test," Chase suggests.
"The guy at the tour bus did mention Sam was friendly with lots of different ladies before he married," Foreman confirms.
"Chances are he could have had unsafe sex," Cameron adds, "I'll run the test."
"A rock star having unsafe sex; now who's being judgmental?" I offer, sarcastically.
"And you're going to need a signed consent for a HIV test; good luck with that one when you run it by his wife," I add.
"The position of his stomach pain suggests acute appendicitis; you should do a CT scan," Cuddy says suddenly.
"Cuddy; doctor stuff going on here. You do the PR, I'll do the medicine," I reply, making it sound as bitchy as possible.
She doesn't bite back. She is up to something.
Everyone in the room looks at me, and I glance at the whiteboard.
"Do the HIV test, the biopsy, and the laparoscopy to rule out peritonitis," I order them.
"And then do a CT scan," Cuddy says. The kids look from me to her; I glance away and eventually nod slightly.
I was going to suggest it anyway.
I look at the board and narrow my eyes.
"Hey Chase; regarding the Coyote's constipation," I say and turn to look at him, as he's preparing to escape from the room, fairly unscathed.
"If you're right, and there is a blockage, he's going to need an enema when you've finished with those other tests," I say and flash Chase a quick smile.
Chase's stare turns into a glare very quickly, but he holds his tongue and leaves the room.
I wait a few minutes, and then leave too.
I really need to speak to band guy now.
Chapter 8: Cuddy
House is up to something, and I doubt I'm going to like it; my bizarre discussion with Wilson earlier left me sure of that. Well, neither of them know anything concrete, just a name, so I refuse to worry about it.
I glance back at House as I leave Diagnostics. He's standing, leaning casually against the conference table, obviously waiting for his team, and me, to disappear from view before he does whatever he's planning to do next. I can tell his leg hurts him a lot today, and he'll do anything he can to stop them noticing, although I know Cameron can usually tell too.
I hate to see him limping. Whenever I see him in pain, it reminds me of the part I played in bringing that about. Stacy really did a number on him, but she wasn't the only one. Sometimes I can hardly recognize the man I knew at Michigan, but now and again, a glimmer of the old Greg slips through.
------
I want him the instant I first see him. I am drinking coffee in the sunshine, sitting on a bench outside the University of Michigan library, trying to finish reading a pathology book before my tutorial. He walks past, a sports bag over his shoulder, and the sun glints in his dark brown hair. I note his powerful walk and distant expression. He doesn't see me. I do some research and find out his name; Greg House, and that he's a grad student, also in medicine. I find out which bars he goes to and finally, a week or two later, we're in the same one at the same time. It looks like an accident, but it's not.
I know I'm looking good; I spent more than I can afford on this top. What I'm not expecting is an argument; one that makes me think. He marked one of my case reports. I didn't know that until he said so - we never know which TA marks what - and it's only after he's spent the best part of an hour deconstructing what I wrote that he says, offhand, "You're much less awful at this than other first years, Lisa," and I suddenly realize that maybe I don't need to drop out after all.
He walks me back to the residences and I know he'd like to come up, but I don't invite him. I'm not afraid of being thought easy; judging by the things I've heard through the walls these last few weeks, I doubt my room-mates would be shocked by anything. But he's a man, not a boy, and I don't want to feel a fool. So I settle for a kiss on the steps; he kisses very well; I feel an unfamiliar stirring in my belly as he tangles a hand into my hair and tips my chin up with the other. Later, in bed, and after every other time I go out with him, I have to bring myself off before I can sleep.
It's Christmas Day when it finally happens. Everyone else is on vacation. I go home for Hanukkah but I come back after a few days to catch up with some work while things are quiet. That's what I tell myself, anyway, because the alternative would be to admit that the absence of my brother still casts a pall over every family gathering.
I bump into him in the empty computer labs, which amazingly, are open this day like any other. I ask him why he's not at home, and then I'm sorry I said anything, when a shadow passes across his face. "I was," he says, and doesn't elaborate any further.
He asks me what I'm working on and, glad to change the subject, I show him. It's an essay on diagnostics, and he goes through the cases I've chosen as examples, not knowing the final one has been a regular feature in my nightmares these last six years. Of course, it's the one he finds the most intriguing, and after a few minutes thought, he figures out exactly what was wrong and sets out what he would have done.
He invites me back to his apartment. He doesn't need to tell me that his two room-mates - fortunately, away for the holidays - are both men. The pile of sports equipment in the hallway, the porn mags in the bathroom and the heap of sweaty sneakers behind the TV tell me all I need to know.
His bedroom, however, is clean enough; not that I have a lot of time to look around. As soon as the door shuts behind us he's got his hands under my top undoing my bra. He's looming over me, blue eyes intent on my face, and I'm suddenly keenly aware of his height. His tongue is in my mouth and his hands are on my breasts, teasing my nipples into tight points, and he's backing me toward his bed.
"Are you safe?" he asks, as he expertly divests me of my jeans and soaked panties, and I thank God I shaved this morning. I nod, because I am still on the pill, despite the fact I dumped my high school boyfriend around mid-term; I wasn't sure why I did it even, but now I think I know. It's a shock when Greg enters me, because there's a lot of him, but I soon adjust, and when I do, it feels amazing, and then when he shoves a pillow under my hips, the increased pressure on my clit makes me come so hard I see stars.
"I like what Santa brought me for Christmas," he says, smirking, as my breathing slows down and I wonder idly whether he actually won all the sports trophies I can see on the other side of the room, or whether they are just for show. And even then, I know this is going to be addictive.
------
I've walked right past my office and am standing, randomly, outside Medical Records before I realize. So I drop in and pretend I'm making a spot check on their audit compliance. After a cathartic - for me - half hour while they scurry about looking guilty, I go back to my desk, where I try, and fail, to concentrate on my email and ignore the message from PR telling me to call back another million or so journalists. All the while, my brain is on a constant loop of vividly-remembered images and sensations I just do not need there right now. So I tell myself three things, sternly.
I do not want Greg House.
I am just a little lonely.
And a woman in my position can't afford to take stupid risks.
Chapter 9: House
I'm waiting outside the Coyote's room, hanging around reception, much to the nurses' distress. I want his wife to leave his room. I'm not in the mood for a thousand worried and pointless questions.
As if somehow, the more informed she is, the better we can treat her dying husband.
I look on the reception chart and see I have half an hour before the first of the scheduled tests begins.
Eventually - finally - his wife leaves the room. I head in, and I'm closing the door behind me before he notices I'm even in the room.
He blinks and looks at me. He's pale, similar to the color of sour milk; off-white and curdled.
Beads of sweat roll down his chin and forehead.
"Who ...are you," he chugs out.
"My name's Dr House; I'm overseeing your case," I say and move closer to him.
He's clinging to his stomach for all he's worth and his breathing is labored; I can tell it's from the pain in his abdomen and not a problem with his chest because he's not wheezing.
He's trying to control his lungs and the searing pain they cause when they fill and empty.
"Dr Cuddy," he begins, and then closes his eyes and seems to cling harder to his stomach.
I notice he's been set up to self-administer his pain medication, and he's not maxed out yet.
I reach over and click the button, until he's two from the limit.
"Mentioned you," he finishes through gritted teeth.
"Did she now; I figured you'd have been in far too much pain to listen to a word she had to say. I have a hard time holding on to her words when I'm not dying."
His features crinkle slightly, and he observes me before closing his eyes again.
I move his hands away from his body, and press either side of his stomach.
Chase was right; it isn't distended, but the `almost' scream of pain he makes when I apply barely any pressure to his abdomen, suggests something is very wrong inside there.
"No...she mentioned you...last night," he stutters out in a whisper.
"Uh huh," I say, almost ignoring him, and then his words penetrate.
"Last night; I wasn't on your case last..." I let my words trail away.
His eyes are closed, and he starts panting.
Bitch, she was going to give it to me anyway.
"She said you're the best diagnostician in Jersey, which is strange, seeing as I have only just met you."
"I don't need to meet you, to treat you, just wanted to see if you were as short as you look on MTV," I reply.
Then a thought occurs to me, regarding something Foreman mentioned.
Past alcohol abuse.
He could be having withdrawal if he never quit the bottle like he said he did. I believe a rock star even less than I believe a teenage heroin addict.
"When did you give up the hooch?" I ask, as he hugs himself again.
"The...what?"
"Booze; they still have beer in England, right? I thought it was the fuel of a thousand football hooligans," I say. He smiles - ever so slightly - although it's gone pretty quickly.
"And I thought all Americans were fat. I gave up drinking two months before I married my wife," Sam says.
I think I like this guy, despite myself. I like people who can hold their sarcasm, even when they're in excruciating pain.
"You sure about that? If the tests we're about to do don't help us to diagnose what's wrong, we'll have to cut you open; that's going to leave a nasty scar. If you're still hitting the gin before a gig, it's better we know now," I say.
He looks pissed at the suggestion, genuinely pissed, and not defensively pissed.
"Hey mate; I don't drink any more, and I don't care what you have to do, as long as it gets rid of this agony in my stomach," he says, and then he lets out a groan with the effort of shouting at me.
"Stop getting all bent out of shape; it's not good for the intense belly pain," I return.
He gets his breathing under control, then gives me a jaded look.
"I think I prefer Dr Cuddy to you; her bedside manner is much better than yours."
"Bedside manner?" I muse, thoughtfully. "I must have missed that class at university; I think I was out getting stoned with my bros that day, but you know how that is."
"I'd take her making up a story about her brother to make me feel better, over you accusing me of being an alcoholic," he says.
I'm about to rip into that one with a cutting reply, when wifey returns from her bathroom break and one little word gets lodged in my brain.
Brother.
Cuddy doesn't have a brother.
I've heard her talk fondly of her sisters on countless occasions; but I'm certain she's never mentioned a brother.
And then I realize she's been acting like she did when her handyman fell off the roof; guilty, and giving out needless personal information. But the burning question is; why should she feel guilty about band guy, and what does it have to do with a brother she doesn't have?
I leave the room, as the Coyote's wife starts to aim a barrage of questions at me. I could only answer her in a language she wouldn't understand, so what's the point? I have no answers for her until the tests come back, anyway.
I don't think the Coyote is lying; I do think he's going to die unless we get to the bottom of this very soon.
But someone else is lying, and I want to know why.
------
I'm sitting in my office at my desk, turning the puzzle pieces over and over in my mind.
It's where I've been for the past two hours.
I'm about to go and get some more coffee, when my memory coughs something up.
For some reason, stuff just comes to me sometimes; it's a gift I suppose.
Information I should have forgotten settles upon me; sometimes it's not remotely important, and sometimes it's vital.
This particular memory is of something Cuddy said to me a few months ago. It was around the time my parents came to visit.
She encouraged me to lie to my mother; when I questioned if she lied to hers:
"Only since I was twelve," was her reply.
It was highly insignificant when she said it then, but now I think about it, it isn't the first time she's mentioned that particular age.
Someone asked her at a fundraising dinner, how long she had wanted to be a doctor. I remember the serious look that crept onto her face as she answered, and the forced smile that followed her answer of:
"Since I was twelve."
And it was an honest answer.
So, Cuddy, what happened to you when you were twelve, that you had to lie about, and made you want to become a doctor?
I don't know, but I quickly work out the year in which Cuddy was twelve.
I log onto the hospital mainframe and soon I'm running the name Cuddy, David, through a birth record database, to see if there is a certificate.
Cuddy grew up in Baltimore.
So I start with the Maryland hospital records first.
It brings up nothing; a prompt suggests I type in the date of birth of the patient.
This is going to take a while. I start younger because I know she's the oldest, so I start ten years younger than her for the date of birth, and work my way to her age.
Nothing. I keep going, maybe he's older; one, two and three years older than Cuddy gives me nothing, but when I type in Cuddy, David, 1964, Johns Hopkins blips onto the screen, and then I find one item on the search index.
I open it up, and I find way more than I bargained for.
And then all but one of my questions is answered.
The who, the what, the where and the how - are solved.
Now I'd just like to know why?
And there is only one place I can find out the answer to that question. It has to be asked, not guessed, or searched for.
Cuddy's probably gone home for the day now; I grab my bike jacket and head out of the office.
Chapter 10: Cameron
Chase and Foreman have scrubbed in and so I volunteer to sit with Cathy while it happens. I feel so sorry for her. I watched several surgeries on my husband, and I remember only too well how it feels to watch people cutting holes in someone you love.
We stare through the glass wall as the instruments are prepared and Sam is wheeled in, his hair a dark smudge against the white pillow.
"I can't believe all this is the result of an asthma attack," Cathy says, brushing a hand distractedly through her short hair, "He's had it since he was a child; it's never been a big problem before."
I don't think this is the time to explain House's theory that the asthma is a symptom, not a cause, so instead I ask, "When did you two get together?"
"At a gig in Berlin," she says, "I was managing this band; a really terrible indie band, and they were supporting The Coyotes one night and I got talking to Sam backstage. Next thing I knew, I'd ditched the first lot and was on tour with Sam. We got together a week later and were married within the year."
"And you're his tour manager as well?" I ask, remembering Foreman mentioning this.
"Yeah. He tours more than half the year; I'd never see him, otherwise. I'd hate to be one of those tag-along wives, flying out to wherever the band is this week." She looks down at the OR again, "What are they doing now?"
I explain what an exploratory laparoscopy is, and that they're going to take a closer look at Sam's bowel, because of what they saw on the CT.
Dr Chen is doing the surgery; I think House had to call in a favor, because it's well known he's impossible to get. So I guess now House owes him big, unless he's got something on him; knowing my boss, either possibility is equally likely. I've learnt a lot from House, not all of it medical.
Something's wrong though; Chen has barely made the incision and done a first sweep of the abdomen when he shakes his head and motions for the stapler, and less ten minutes in total have passed before he's closed and Sam's being wheeled back out of the OR again.
Chase looks up at me; fortunately he's not tactless enough to give a thumbs down while the patient's wife is sitting right beside me, but his expression is grim and I can tell from his tense body language that whatever they've found inside Sam's abdomen is very bad news.
"It's all done," I say to Cathy, in what I hope is a reassuring tone, "We should go back to the room now, then you'll be there when they bring him back." She nods her head and follows me.
But as we're walking back downstairs, I get a page from Chase to say that they've taken him straight to ICU.
------
I have been in so many ICUs, all different, but relatives always do the same thing. They go in, looking nervous, then they approach the patient; then they think about holding their hand but back off when they can't work out how to get round all the wires and tubes and monitors.
Sam is heavily sedated and will stay that way until we figure out what to do. Dr Chen found that the huge numbers of white cells Sam's body had been producing had settled around his small intestine. As a result, his bowel has almost completely rotted away inside him; damage to the blood vessels has caused peritonitis and gangrene.
Cathy turns to me, as pale as chalk, and asks the sixty-four million dollar question, "Is he going to die?"
And I think he probably is.
Chapter 11: Cuddy
When I get home, I find House sitting on my doorstep, reading a gossip magazine. His ridiculous orange bike is parked in my driveway - or perhaps abandoned would be a more accurate term. Fantastic. Now he's stalking me. This is exactly what I need.
"Take the scenic route? I've been waiting ages," he moans, which is a bit rich considering that I didn't ask him to come. In fact, I would probably pay him to go away. I wonder for a second if this is his latest idea to get out of clinic hours; refuse to let me in my own door until I agree to whatever he's got in mind.
"I'm surprised you didn't just break in," I say, testily, glad that I moved the key from under the flowerpot after his last impromptu visit.
"I leave that sort of thing to Foreman," he replies, loftily, hauling himself to his feet and stepping to one side so I can open the door.
I slam the door behind him with a bad grace; throw my coat and briefcase on the hall chair and turn to face him. At least this way we can have the inevitable argument in private, rather than providing a free show for my neighbors.
"Shouldn't you be at work, House?" I ask, making no effort to conceal the fact I'm pissed. "You know, dying patient and all that?"
"Dastardly and Muttley can observe a laparoscopy without me," he says, dismissively, "And St. Cameron's there with the wife; they can page me when they've got something to tell me."
With that, he pushes past me and limps into my living room, where he lowers himself into an armchair, and removes a manila folder from inside his leather jacket.
"Oh, make yourself at home," I say, "I'm all ears to hear what it is can't wait until we're both at work tomorrow."
I switch a lamp on, perch myself on the arm of the couch and kick my heels off; I'm tired and hungry and I could use a glass of wine, but I'm damned if I'm going to offer him a drink.
He looks up at me and then glances back down at the folder in his lap.
"This is David's file," he says, and waits for my reaction.
I feel as though he's slapped me. I can't think what to say, and so I concentrate very hard on the way the light from the lamp reflects in the polished wood floor, while I try to suppress the rising tide of bile in my throat.
When I can speak again, I ask, "And this is your business, because?" and I want to sound authoritative, as I normally would when telling him off for something outrageous he's done, but I can hear my voice shaking, and I hate it.
And eventually, he says, quietly, looking down at the file and not at me, "Because I want to know why you feel guilty about something that wasn't your fault."
"Give me that," I say, and he passes the file to me, and I sit down on the couch and open it with clumsy hands. We sit in silence while I read, and I remember the worst day of my life.
------
The car pulls up in the driveway just after one o'clock on Sunday morning. I've been in bed a couple of hours but I couldn't get to sleep. I put Jenny to bed just after David left, and finally got Ruth and Rachel to do likewise about ten, after major threats involving me telling my mother to ban them from TV for a week, which they know she would, because she has before.
I hear David let himself in the side door, walk through the house, use the bathroom and come upstairs. I want to check he's okay, but on the other hand, I'm still so angry with him that I don't want to speak to him right now. I hear him pause outside my door, but I lie very quietly, listening to Jenny's even breathing from the other side of the room, muffled slightly by the curtain that separates her half from mine. And after a while, I hear his footsteps continue in the direction of his bedroom.
The next day, it's late by the time I've managed to evict the twins from their comfy beds and persuaded Jenny to get up and dressed. This is followed by her taking all her clothes off while my back's turned and then I have to get her back into them again - Mom says she's going through an exhibitionist phase.
We all eat cereal, even though it's practically lunchtime, and it's only when I'm telling Ruth not to feed Jenny another bowl of chocolate frosted flakes, because she's practically bouncing off the ceiling with caffeine as it is, that I think to wonder why David's not up. He does like to lie in bed, particularly when our parents aren't here to find him chores to do, but it's not like him to miss a meal.
I go upstairs, trying not to notice that Jenny is now wearing her cereal bowl as a hat and has milk running down her nose, and knock at his door. I get no response, so I knock again, more loudly, and am rewarded by a muffled groan.
I push the door open, and as I expected, my brother is lying prone in bed. I move closer and notice he doesn't look so good; the parts of his face which aren't flushed red are an unpleasant shade of whitish-green.
"Are you all right?" I say, tentatively, not wanting to be too sympathetic. I doubt he'd drink and drive, but then, before last night, I wouldn't have thought he'd yell at me and run off with the car keys, either. He doesn't respond, so I pull the covers off him, and he shouts and clutches at his stomach.
"Does your tummy hurt?" I ask, now getting worried. He nods his head, and whispers, "Gonna throw up." I run and grab the first container I can find, which is the trash can, and he retches into it. Gross.
"I should call Mom," I tell him, "Or the doctor. Or maybe both."
I really don't want to call our parents though, because it's their wedding anniversary, and they've gone to a cottage my aunt and uncle own on the lake, and they hardly ever get to borrow it. And if David and I go to the doctor and don't ask them first, they're not going to be very pleased, either, because our health cover was with my Dad's job, and he was laid off six months ago. Then I think that I could call my aunt at her office instead - but I remember the row that happened after she got David his expensive guitar, and think better of it.
So I'm relieved when my brother says, "No. Don't. It's just a bug. I'll sleep it off."
"You don't think it's your appendix?" I ask.
"No. It feels completely different to that," he says, pulling himself up to a half sitting position, and looking like he's going to spew again for a second, but then managing not to. "Anyway, they said the antibiotics had fixed it, didn't they?"
I remember all the fuss that was made of him when he had to be admitted to hospital, and the sense of anticlimax when he was discharged after a couple of days with just a packet of pills and without the dramatic scar he was hoping for.
"Okay," I decide, thinking aloud. "Just stay there. If you still feel bad tomorrow, Mom can take you to the doctor when she gets back."
"Keep the kids out of here, will you, Lisa?" David asks, turning over carefully and lying back down on his left hand side.
"I'll try," I say, gloomily. It's going to be even more impossible to stop them running wild without his help, but I'm going to have to do my best.
Mom calls that evening, and when she asks, I tell her everything's fine. David has seemed a little better during the afternoon, and even got up and watched TV for a couple of hours while the others were out on their bikes. She asks to speak to him, but I lie and tell her he's round at his friend Pete's, because I know he'll sound funny.
The next morning is the usual mad dash to get my three sisters dressed, fed and off to school. I don't even have time to check on David, because every minute between six and seven a.m. is taken up with one crisis after another, from Rachel's missing hair slide to Jenny's mini-tantrum when I try to get her to finish her toast. I'm feeling quite weak by the time I pack them on the school bus, and looking forward to tomorrow, when Mom will be around to help.
"David!" I shout, as I go back up the stairs. I doubt he's feeling like school, but if he's not going, I need to know. I have to leave myself in a few minutes and I want to borrow his bike, because mine has a puncture.
And that's when I find my brother passed out on the bathroom floor in a pool of blood and shit.
------
I leaf through the file, while House watches me silently. It's all here, and even as my anger builds at him for confronting me with this unwanted relic of my past, a small part of me is admiring the efficiency of Johns Hopkins' record-keeping. I find notes of the tests they did on David when he was first admitted with what was thought to be a grumbling appendix, and a copy of the script for antibiotics, together with a discharge summary.
The next few sheets are the ER admissions forms from six months later when we went to the hospital in an ambulance, that Monday morning when I finally figured out there were worse things than my parents being angry at me for spending money we didn't have.
Toward the end of the file, I find a note from the attending to the effect that, as the patient is only accompanied by a minor, they can't operate until they have parental consent. It's stapled to a fax to a legal firm asking them to start proceedings to make David Cuddy a ward of court. And I know full well what the final leaf of paper will be, and I don't want to see it.
------
No-one can get hold of my parents. There's a phone in the cottage, but they're not picking up; they've probably already set off home already. I offer my aunt's number, but she's not reachable either. Morning turns into afternoon and David rouses a bit, and asks for Mom. He doesn't know where he is or who I am.
Medical staff scurry in and out of the room, taking an increasingly urgent series of readings and conferring in whispers about things I don't understand; one word they keep saying is peritonitis. I hold my brother's hand, but he's barely conscious now, because of whatever they gave him for the pain; he's hooked up to wires and tubes and has a breathing mask. He looks scary now, like a robot.
One of the machines starts bleeping in a frantic kind of way, jerking me out of my half-doze, and I'm suddenly being taken out of the room, and a nurse makes me sit in a small room down the corridor, and I don't want to stay there, but I don't quite dare go back in David's room, either.
After a long time, the nice lady doctor comes into the room and tells me my brother is dead. I don't cry, because the whole day has felt like a strange dream, and I think that if I pinch myself, I'll be back at home, and David will tell me to stop being so silly. It's only when I walk back into our house, after a terrible car journey of Mom weeping and Dad telling her it's not her fault, that I truly realize whose fault it is.
------
I put the papers carefully back into the file again and put it down on the coffee table.
"This was the case you told me about at Michigan, wasn't it?" House says, quietly, "An undiagnosed appendicocutaneous fistula; atypical presentation without pyuria?"
I close my eyes and continue, "Leading to peritonitis, septicemia, shock and death. A CT would have probably saved him, but they didn't get one until the following year. Ironic, isn't it?"
I think of the ultrasound I've just looked at in the file, which provided you know what you're looking for, clearly shows the attachment of the engorged appendix to the bowel.
House clears his throat. "Cuddy...Lisa. This was NOT your fault. If anyone's to blame, it's the doctors who discharged him in the first place and didn't do any follow up."
If I wasn't feeling like crap I would call him on that one. Because House is so well known for his diligent approach to following up on patients.
"My dad lost his job the week before he was admitted the first time," I tell him. "It says in the file they were advised he should have the operation, but they couldn't afford it."
"It still wasn't your fault," he repeats, getting to his feet and coming over to where I'm sitting.
"It was my fault," I tell him, feeling a tightness in my chest, "I was the one who delayed. The delay killed him. I should have known."
"Yeah, you're right," House says, in his favorite patronizing tone, the one he likes to use on clinic patients, his team and well, me, "You should have been able to see the future. You, a twelve year old girl, should have been able to take care of three little kids, one stroppy teenager, and diagnose a mystery illness that actual, if moronic, doctors had told you was fixed."
I'm suddenly so angry that I can hardly breathe, and I'm on my feet, in his face, because I will hit him if he says another sarcastic word.
"Do you know why I'm always on your case about that fucking clinic, House?" I shout at him, and I've obviously surprised him, either by the swearing or the shouting, because he just stands there and watches.
"It's not because it says you have to go there in your contract, or because I think it'll do your soul good, or even because I just love busting your ass. It's for the simple reason the people that go there can't afford to go anywhere else, and you're the best diagnostician we've got. I know damn well you could have cured David, but there was no House, no clinic and I lost my brother and I'm never going to get him back."
I choke on the last few words, because I'm crying, and I put a hand to my face. I can hardly bear the shame of it. I hear the creak of a leather jacket, and House reaches an arm out to me and pulls me to him, and I think I'm hallucinating, because I can't believe he would lose this golden opportunity to mock me some more.
At length, I come to my senses and realize whose shoulder I'm weeping on, and that this can't end well.
I take a step back and look at him through blurry eyes, but he doesn't say anything, simply hands me a handkerchief, and I blow my nose. I look up, afraid of what I'm going to see; afraid I'm going to lose it again, but to my surprise, I can't see anything but sympathy in his blue eyes.
And then I'm doing something I swore to myself I never would again; something I have spent years perfecting a system to avoid happening.
I'm kissing Greg House.
Continues in Part 4
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Legal Disclaimer: The authors published here make no claims on the ownership of Dr. Gregory House and the other fictional residents of Princeton-Plainsboro Teaching Hospital. Like the television show House (and quite possibly Dr. Wilson's pocket protector), they are the property of NBC/Universal, David Shore and undoubtedly other individuals of whom I am only peripherally aware. The fan fiction authors published here receive no monetary benefit from their work and intend no copyright infringement nor slight to the actual owners. We love the characters and we love the show, otherwise we wouldn't be here.
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