Jon White

909-534-1783

Short Story

Lit. Week 2008

Desperate Diagnosis

Part 1 of 2

"Good evening Doctor," the cheery desk nurse greeted House as he shuffled into the clinic. "Your words, not mine." House didn't like clinic duty, but if you didn't already know that then you have no business reading this story. "Your first patient is Ms. Warner, she's in exam room three. She is complaining of hypersomnia." For those of you without medical training, it means she is tired for no reason. House stumbled into the exam room, to begin his long boring day. "I'm tired all the time,"

"Yes, Ms Warner. Is there anything else you wish to tell me?"

"No, I'm just tired." How wonderful it is that people can be so helpful. House sighed to himself. "Are you under any particular stress lately? Any major change in your lifestyle?"

"No, I'm ju-"

"Yeah, yeah. You're just tired. Are you taking any medications?"

"Um, let's see. Eye drops, hand cream. Oh, and Ambien" House stared at her, a look of disbelief on his face. "You're taking Ambien?" "Yes." "As in the chemical zolpidem sold under the brand name Ambien?""Yes." "You are aware that Ambien is a sedative.""Yes, do you think that this is a side effect?""No, I think that it is the main effect. Your sleeping pills are making you sleepy. Hence the phrase 'sleeping pill'. Perhaps you should stop taking the Ambien." "But how am I supposed to sleep?"And that was just about enough. House rolled his chair to the desk, pulled out a prescription pad and began writing. "Follow these instructions and you should be just fine" He ripped the sheet off and, handing it to the lady, walked out. Ms. Warner turned the piece of paper over and read the note which said"GO AWAY AND DON'T COME BACK"

"Diagnosis, severe brain damage." House put the file on the nurse's desk. "Brain damage? She seemed fine to me."

"You didn't spend five minutes trying to explain why sleeping pills cause hypersomnia" The nurse smiled at House and gave him another file. "Mr. Cartier, room seven. He declined to say why he needed assistance"

"Wonderful, that means it's too embarrassing to tell everyone and I'll probably end up covered in something unpleasant" House walked into the exam room and saw a young man who looked more at home at a rock concert "Well Mr. Cartier, what seems to be the trouble?"

"Hey, dude, could you give me some of that medical marijuana" Good lord the nerve of some people. "Can you give me a good reason for this prescription, dude?"

"Uh yeah, I've got that," at this point the pulled a scrap of paper out of his pocket "Glo-ca-ma?" "You mean glaucoma." "Yeah, mine's so bad I can hardly walk" House muttered something rude under his breath and said aloud "Glaucoma is a retinal disorder, it means you have diseased eyes" The patient paused for a moment and said, "Yeah my eyes are so bad I can hardly walk." House began to yell something at the stoner, but then he smiled and pulled out his prescription pad. "Here, I'm going to write you a prescription for THC pills, it's pretty much the same thing" The Patient was incredulous "They make chronic in pills? Dude!" and after high-fiving House, he left.

"You're not covered in anything" the nurse remarked as House twisted the top off his Vicodin. "He wanted a hash fix, so I wrote him a prescription for THC in pill form." The nurse looked up at him "Doesn't that cause horrible nausea?" House shrugged and said "Oops" The nurse threw him a dirty look "You know, you really shouldn't have done that"

"I was saving that boy's life. Everyone knows that pot is a gateway to other stupid behavior" The nurse mumbled something which sounded vaguely like 'Vicodin' and handed House another file. "Mr. Jacobi is in the room nine, his son is not well." "Good evening, I'm Doctor House. You told the nurse that your son is ill." The man said to House "I think my son is pregnant" Without saying another word House turned around and left the exam room.

The nurse was walking back to her desk when she saw House come back to the waiting room "That was fast." House replied "They left before I went in." "That's odd, I didn't see them leave" "Well, the dad was long gone by the time I got there." The nurse reached over and grabbed another file "Your last patient today is Mrs. Hart, she says her baby is ill. She's in room four. " House groaned "A paranoid mother who thinks her baby is dying, lovely." The first thing House saw as he entered the exam room was a perfectly healthy looking baby. The second thing he saw was a woman on the verge of collapse. "I'm Dr. House, what seems to -"

"Doctor, something horrible has happened to my baby." House tried to calm the woman, "Ma'am, please relax. Have a seat. Now tell me. What is wrong with your baby" The woman sat down and said "The other day, Suzie...sh... she swallowed a quarter" House was loosing his patience (not a pun) "Ma'am, babies swallow change all the time. There's nothing to worry about, just wait for it to pass through her system." "Well, that's just the thing. It did pass. I noticed it this morning when I changed her diaper" "Okay, then why are you worried?" "Well, it was...she.. I saw... Well, here" And she held up a small zip-top bag. House looked in the bag and his jaw dropped. He had been a doctor for nearly twenty-five years and he had never seen anything like this. Inside the bag were two dimes and a nickel.

House, handed the nurse his last file, he still had a dumbfounded look on his face. "What's wrong? Is the baby alright?" House looked at her and said "Call Commerce Bank." "Why?" "I've just found a race of human ATM's." And with that, House left the clinic, and went home.

End of part 1

Part 2 of 2

The next morning

Doctor Cameron makes her way into the next patient's room with her typical annoyed look advising anyone who thinks about bothering her to think again. Her tall imposing figure is made more commanding by the ominous black suit she wears in place of a lab coat. "Good morning mister... Stanner. What seems to be the problem?" Alex tells her to shush her mouth for a minute and resumes talking. "So anyway, I'll have to get back with you later Jeanine, but you MUST record Desperate Housewives for me, okay? I might be missing it tonight... and please, don't make me eat hospital food, could you bring me something to eat? And my shampoo, this hospital shampoo is like hotel-- Jeanine? Are you LISTENING to me?" Dr. House glares daggers at him while twirling the disconnected phone line in his hand. "If your primary complaint is that you'll miss Desperate Housewives then the only treatment you'll need is a VCR." Alex blushes and starts nervously chattering, before House interrupts him once again. "This isn't The View here, tell me what's wrong with you!" He sputters out, "I've been fainting a lot! I'll be minding my own business and feel a bit lightheaded then suddenly I'm on the floor looking up and everyone is staring down at me! Though this one time, Sam tried to give me artificial respiration, that was sort of nice..." The look on House's face seems to just ooze a sarcastic "Fascinating." He looks at his chart, sees the blank spaces next to "Vital Signs," and storms out of the room bellowing, "WHY HAS NO NURSE SEEN THIS PATIENT YET?! HOW AM I EXPECTED TO EVEN BEGIN DIAGNOSING SUDDEN FAINTING WITHOUT KNOWING WHAT THE BLOOD PRESSURE, HEART RATE, AND RESPIRATORY RATE ARE?!" Alex has turned as pale as a sheet and looks like he'll faint again soon, which prompts Dr. House to run back in there with a blood pressure cuff. His eyes feel soggy... or drippy... or what is the right word... for ... want to close... He grabs for a pulse and finds it faint and slow. His fist slams against the Code Blue button above the exam table while He shouts out the room, "GET A CRASH CART IN HERE, WE HAVE A PATIENT BRADYING DOWN!" His stethoscope flies to her ears and to Alex's chest, where there is faint breathing sounds against a background of a slow lub-dub of the heart. As the resuscitation team arrives, she hooks him up to the monitor, finds a perfectly normal albeit slow heart rhythm, and starts an IV with medicines in it. Jeanine is looking at him, stroking his manila hair. Alex wakes up, sees her, and says, "I'm glad you came here, I had another spell..."

She replies, "I know, the doctor explained it. She said your heart slowed down and your blood pressure dropped, which made you faint. I'm so glad we could afford coming to Plainsboro Hospital, the building is phenomenally beautiful, almost like a castle!" She breaks off a second and queries, "Alexei? What's wrong?" She wipes a tear from his face with her finger. "I'm sorry! I don't know why, I just--" He starts sobbing into her arm, and her face reflects a look of concern and perplexion. She pulls him up onto her shoulder where he keeps sobbing for a few minutes, then as suddenly as he started, he stops. "Did you remember to bring me some food, and my shampoo? I absolutely hate this hospital food, it tastes so grody! And my hair... ew, it's starting to get oily!" Jeanine looks even more perplexed. "Alex, are you sure you're okay?"

"Okay? I'm more than good, I'm grrrrrrrreat!" She grabs the nurse button and says, "Please come in here, he's acting strangely!" Alex suddenly grabs it from her hand and says into the microphone forcefully, "I am fine. There is nothing wrong with me. Don't you dare come in this room!" When the nurse arrives, with Security and her friend from Psychiatric in tow, she finds Alex staring blankly ahead and Jeanine frantically trying to make him talk to her. "Alexei! Please say something! Alex!" She turns to the nurses and says, "He suddenly got sad, then was happy, then angry, and then just stopped moving!" The nurse grabs the phone, dials 7243, and then "Paging Doctor House to room 315" echoes throughout the hospital. "Okay, so now we have three symptoms. Catatonia, labile affect, and vasovagal syncope." He orders a battery of tests, which show several minor deviations, such as a slight lack of oxygen getting to the heart, but not nearly enough to cause the fainting episodes, a small amount of cocaine in the blood, but also not enough to have any effect on him anymore, and a lot of lactic acid in his blood, but apparently it's been there long enough that his body has compensated for it successfully. Nothing conclusive really. An MRI of the head is mostly normal except for a tiny swelling of the brain, that could easily have been caused by the fainting. The chest X-Ray shows some swelling of the lungs, which cocaine use tends to do. Dr. House however is not satisfied with "random fainting" and "Cocaine-induced mood disorder." Alex stares in horror at the huge shadow standing in front of him. "What are you-- go away! Don't kill me!" Dr. House stares at him with a look almost indicating apprehension, then looks at the thin air in front of Alex. He quickly tells him, "There's nothing in front of you." Alex screams, "GET IT AWAY! IT WANTS TO KILL ME!" He grabs up the sheets as if they were a shield and backs up in his bed with a look of pure terror in his eyes. Dr. House grabs the phone and quickly says "Psych to 315, psych to 315!" When He gives him two milligrams of Haldol in his IV, he looks a bit less awake but now is mumbling, "Get it away, away, away, away, away, I don't want to die, it's going to kill me, I have to get rid of it, where is the Bible, it wants me dead, Jesus save me," and another two milligrams of Haldol make his eyes close for the next six hours. Alex awakes humming Mozart's Requiem, claiming "I can hear it, it's playing right now through those speakers! Duh, why do you think I'm humming along with it?" The psychiatrist, neurologist, and nurse all have differing opinions as to the cause. Dr. House orders the nurse to "Take him over to Neuro and get a spinal tap, EEG, and repeat the blood tests to see if the lactic acid level has changed." Alex interrupts, "Are you people just trying to steal my blood?! You've had enough already, get more from some unwitting blood drive donator!" The technician is inserting the spinal tap needle into Alex's back when suddenly, a piercing sound makes him jump, and the needle flies out of his hand. "What the-- CODE BLUE!" He quickly rolls Alex over and starts pressing on his chest, while Alex looks at him as if he were being shot. He can't speak at all and can't move, but his mind still barely works since his heart is beating ineffectively but not totally so, and the chest compressions are helping a little bit. When the crash cart arrives, Dr. House who was supervising the spinal tap grabs the defibrillator paddles, a nurse puts gel on them, and she charges it. Once the quick triple-beep sounds that it has charged, she gets the technician "Clear!" and shocks a terrified Alex, whose heart begins beating right again. He soon is screaming, "GET THAT MURDERER AWAY FROM ME! SHE'S TRYING TO ELECTROCUTE ME! AND THAT OTHER ONE, HE TRIED TO CRUSH MY CHEST AND BREAK MY RIBS! GET THEM OUT OF HERE!" The Haldol has once again worn off, and Alex is staring angrily at the shadow again. "I'm not afraid of you, now show yourself! Let me see your true face!" The figure complies, and he sees its face. "Doctor House. I should have known it was you when you tried to electrocute me! I'll kill you, I swear I will!" The figure does nothing but sing. "Lacrymosa, dies illa, qua resurget ex favilla, judicandus homo reus," it says, "Mournful day when from the dust shall rise guilty men to be judged." Jeanine begs Dr. House, "Please, he is never like this! You have to believe me, he doesn't do things like this!" The annoyed doctor snaps, "I know that already, no one who doesn't have brain issues acts like that! I'm here to ask your permission to get a court order for electroconvulsive therapy. That's when a small shock is delivered to one side of his brain to cause a seizure which treats mood disorders, but because of that idiot Ken Kesey who wrote One Flew Over the Cuckoo's Nest, the whole world thinks it's a horrible punitive method of getting rid of people that psychiatrists don't like. Either give me consent or don't, but I'll tell you now that anti-psychotic medication isn't working so far and ECT is the most effective method that exists." A rather tearful Jeanine consents and signs a form releasing the hospital of any damages caused by the treatment other than those relating to gross negligence or malpractice. "You won't get away with this you fallen Angel of Death," Alex tearfully utters as Dr. House wheels him into the ECT suite. The muscle relaxant/sedative IV drip, anesthesia machine, cardiac monitor, and brainwave monitors are activated. Next comes the ECT machine. The procedure goes off without a hitch, except that when Alex awakes, he still is swinging from mood to mood and fears that the entire hospital staff wants him dead. Jeanine pleads, "You have to let us help you Alex, I love you! When I married you, I agreed to stand by you in sickness and in health, but you act like you want me gone from your side!" With the tears rolling down his face, he accuses, "The only part of the marriage vows you seem to be concerned with is 'till death do us part', since you're letting these bastards kill me!" Shocked, she replies, "I would never--"

"OUT! IF YOU WON'T FREE ME FROM THEM THEN I WANT YOU OUT OF MY ROOM!" She storms out of the room to hide her tears. Dr. House is thoroughly baffled. He's had tests and consults repeated but nothing seems to work. When He has cases like these, He sits down in the Doctor's Lounge to discuss the case with whoever is there to listen, even though people sometimes nervously inch away from him wherever He is. "It can't be schizoaffective disorder, that doesn't have such rapid onset. The cocaine is completely gone from his body according to the blood tests so it couldn't have caused the cardiac arrest. The cardiac markers are negative so there was no heart attack... where are all the symptoms coming from? Paraneoplastic Syndrome?" He pops an almond into his mouth and stops cold. His thoughts race for a second then He suddenly flies off the couch, down the hall, and into Room 315. Alex is sleeping thanks to yet more Haldol, so He draws blood from his IV site and runs down the hall, up the stairs, and into the Hematology/Pathology lab. "I need a stat cyanide level!"

The lab tech says, "We're backed up doing trauma panels because of that seven car pileup on the interstate. It'll be about an hour and a half." From within House's purse comes a fifty dollar bill, and then five minutes later from the lab technician's hand comes a report for Serum Cyanide Level: 74 mmol/L. Not toxic enough to cause immediate symptoms, but enough to cause chronic symptoms. Dr. House grabs Jeanine by the hand and leads her up to the room with no warning. "What's going on? Is he alright?"

He answers, "He'll be fine. Where does he work, and what food have you been bringing him?" Jeanine thinks for a moment before replying that he works at a small company that processes Cassava, and she brings him his favorite dish, lima beans. Alex perks up when they enter the room. "Hiya! Where have you been?" Jeanine is once again shocked, this time to see him acting so much like himself. House points to an IV drip and says, "Cassava and lima beans both contain cyanide. If processed improperly then the cyanide can cause chronic poisoning. If you give us the phone number to where he works then we can notify HAZMAT--" He spots Alex and Jeanine not listening to him anymore and says, "Oh get a room you two!" then storms off to call the fire department himself. "Did you record Desperate Housewives for me?"

"Of course I did baby, but I can't wait long enough for you to watch it to tell you the news: Bree is pregnant!"

"WHAT? Bree?! That's, like, impossible! I don't believe you, I'm calling Jake up to ask him!" He reaches for the phone and dials the number, his arms reaching around the IV containing the drug that saved his life.

End.