Tales of Coming News
I'm so tired of hearing tales of coming news
Tellin' tales of a changing sky
Just a shame that I didn't notice you
Till someone I loved had to die
You never used to let me go unfeigned
I was so distracted I never saw the rain
You promise you meant every word you said
I wonder when did all that change
I sent a message, said I'd be gone forever
A letter of reply never came
She said that she'd be true but I wouldn't let her
I wonder when did all that change
"Ok Jared, let's read this book, then we'll go get a soda." Dr. Carrington handed the little boy sinking into the couch a book. "If You Give a Mouse A Cookie." She smiled, "You like cookies, don't you, Jared?"
The little boy nodded his red head.
"Let's sit down at the table." She pointed at the desk across the room. She started to get off the couch when the boy started crying. She continued across the room and sat at the table and stared at him mutely. He threw himself back and cried uncontrollably
Dr. Carrington was silent as the boy started pounding his fists into the couch. As she began to rise to leave the room, he started shaking.
"Jared." Dr. Carrington stopped, noticing he was no longer crying. "Jared?" The boy continued to seize. "John!" Dr. Carrington ran to the two-way window. "Call 911!"
*
Standing in the doorway to House's office, Dr. Cuddy stood with arms crossed waiting for him to notice her. Slowly, he looked up and opened his mouth to speak. Cuddy wouldn't let him. "You have a case."
"A what?" He cocked his head to one side
"8 year old boy with Asperger's and selective mutism presenting with nose bleeds and frequent absent seizures." She walked forward and threw a folder on his desk. "And don't say you're not interested. He's spent the last week at Children's National Medical Center in D.C."
"You had me at selective mutism." He grabbed the file and opened to the first page
"His parents are British diplomats on assignment in Bahrain. They want answers now." She crossed to sit in the chair across from him
"Since when do we bow down to British spies?" His eyes locked with hers over the file
"Because they're on assignment, they're virtually unreachable. His legal guardian and medical POA is his behavioral therapist at The Children's Institute." She paused, "House, I think you should know,"
"I know." He cut her off "I can read. Don't try and talk me out of it. It's not that interesting of a case… but selective mutism! It fascinates me!"
"You can't possibly understand someone who can't talk?" Walking in the door, Dr. Foreman introduced himself into the conversation
"Ah, he CAN talk, he just DOESN'T talk." He grabbed his cane and stood up. "What kind of behavioral therapist does he have if she can't get him to talk?"
"House…" Cuddy warned
"I've been by to see him." Foreman continued from Cuddy's cue. "He talks to his therapist and his nurses. She's been working with him to be comfortable talking with everyone else."
"Well then, gather the team. Maybe he'll talk to one of you." House hobbled into the other room as Cuddy followed him. "And you can call the British government and tell them I will have him fixed and talking in no time."
"House." She stopped and crossed her arms "Don't do this."
"First you tell me I have to take the case, now you tell me not to?" He rolled his eyes. "Women."
"You know what I mean." She started to walk out of the room, then stopped abruptly. "Dr. Charlotte Carrington is the best behavioral therapist at The Children's Institute. You do your job and she'll do hers. Never the twains shall meet."
Leaving him standing there staring blankly, she whipped around and waltzed out.
*
Dr. Charlotte Carrington sat beside the little boy's hospital bed singing softly as she held his hand.
"Go to sleep my little hobo, let the towns drift slowly by, tonight you've got a nice warm boxcar, that's the hobo's lullaby…" Thinking he was asleep, she slowly put her head down against the edge of the bed and closed her eyes.
"I don't want to sleep." Jared whispered.
"Jared," Charlotte looked up at him, her bright blue eyes capturing his round brown ones. "The sooner you fall asleep, you know what happens?" He shook his head "The sooner it's tomorrow. And tomorrow is another day closer to your parents coming home." The boy smiled and settled into the pillow.
Thirteen slid open the glass door and looked at the picture. A little red headed boy, small for his age, was dwarfed inside the hospital bed. Beside him sat an angel. Long, loose blonde hair and bright blue eyes. She looked old enough to be his mother, but too young to be considered one. She wore jeans and sneakers, but was wearing a neatly pressed cardigan and had her designer briefcase sitting beside her big, sloppy purse.
"Dr. Carrington?" Thirteen cut off her own reverie. Charlotte looked up and placed a finger on her lips. Slowly, she reached for her briefcase and stood up, leaning over and whispering something in Jared's ear.
She motioned for Thirteen to follow her out of the room, glancing over her shoulder to give Jared a reassuring smile.
Once outside, Thirteen started, "I'm Dr. Hadley. I work with Dr. House. I need to get as detailed of a history as I can get."
"I figured." Charlotte reached into her briefcase and pulled out a file folder "You already have his records from Children's National, these are from his stay at the Institute. He never had more than a sniffle in the 18 months he was with us." She pulled out another large folder, this one being held together by a rubber band. "And these are my personal notes. Detailed therapy plans, all my pre-evaluations including baseline testing, and daily accounts of our sessions."
"Wow. Um," Thirteen grabbed the second file and almost buckled under the weight.
"It doesn't look organized, but trust me, it is. Everything has dates and times and it's all in chronological order." Charlotte smiled. "That's all I have."
"You don't happen to have any medical information on his parents?" She looked hopeful
"It's in the intake report." Charlotte pointed at the first folder.
"Alright then, I'll get started on these. If you happen to think of anything that is not in these reports, please don't hesitate to stop by and let us know." Thirteen looked at the boy through the glass "We will find out what's wrong with him."
"I know you will. Dr. House has a knack for taking impossible cases and making them seem stupidly simple." Charlotte smiled her reassuring smile at Thirteen
"It's like you know the guy." Thirteen laughed then sobered up quickly. "I better get going. Lots of paperwork to catch up on."
*
"Well, I liked Dr. Carrington." Thirteen walked back into the office, carrying the armload of files.
"You would." Kutner snipped from his position at the table
"I did some research on her," Foreman injected "You know she's only 25? She's apparently a genius. She got her PhD in Social Intervention at NYU and worked in rehab facilities for a few years before switching to children's therapy."
"She belongs with children. She's so soothing. She smiles at you and it's as if your confidence goes through the roof…" Thirteen marveled.
"Yeah, yeah, a regular Mother Theresa." House came bursting through the door from his office. "So what about the kid."
"Mother Theresa takes good notes." Taub flipped through Charlotte's personal notes. "10:13am on August 23rd. Jared walked into my office with his arms hanging down to the side… The nurses informed me they allowed him to dress himself. He was wearing a black t-shirt with his jean shorts. He wasn't wearing shoes… He was unresponsive to the usual greeting... He sat in the corner of the couch farthest from the window…" He scanned over that day's notes.
"…He mentioned he caught some rare infectious disease?" House quipped as he walked over to get coffee. "So what do we know?"
"8 years old. Asperger's Syndrome. Selective mutism. Nose bleeds. Seizures." Foreman shrugged
"Parents are British diplomats." Kutner continued
"Or spies." House added, "Most likely whatever is wrong with him, we can blame the parents. It's always the parent's fault. So what about them."
"There isn't much known. What we do know is in the intake reports for The Children's Institute and since they aren't a medical facility, it's not very thorough." Thirteen opened up the intake file
"So what is there?" House asked, getting frustrated
"He was born in London. At 6 months, they moved to Lithuania. 14 months, Fiji. Age 2, they moved to Chile. Age 3, Stockholm. Age 5, Niger then Lebanon. Age 6, back to London. Age 7 he was in The Institute." She read off
"So he's moved around a lot. Maybe he contracted TB or Burkitt's lymphoma." Taub suggested
"Burkitt's is unlikely. He'd have to have a viral infection and malaria. Maybe a worm?" Kutner grabbed the intake file
"Have you forgotten the symptoms?" House grabbed a marker and wrote up "NOSE BLEEDS" and "SEIZURES" then turned to them "Fever?"
"Low grade." Thirteen nodded, looking at the charts. He turned back around to write it up. Sharply, he turned back around, walked into his office, grabbed his backpack and continued talking. "Do a full blood panel. It's probably some tropical disease from living in all those unclean places growing up." He shuttered.
"They did blood panels at Children's National…" Thirteen tried to stop him
"Well, do them again. Do you think just because they're catering to kids of politicians that they're perfect?" He started out the door
"Where are you going?" Foreman started to chase him down
"I have to see a man about a horse." And with that, he was gone.
*
"Charlotte?" Cuddy crept into Jared's room. Charlotte, who had been pouring over notes, looked up. Cuddy searched her face. Her normally bright blue eyes were tired. Her hair was thrown into a messy pony tail, tied up with a piece of latex normally used as tourniquets for injections. Desperately Cuddy tried to find the little girl she once knew, but only saw an exhausted psychologist.
"Lisa. It's good to see you." Putting down her papers, she stood up and embraced the other woman. "They've been doing tests on Jared for days and no one has said anything."
"Charlotte," Cuddy looked at the sleeping boy "House sent me to tell you they found an infection in his spleen. Spherocytosis"
"An infection in his spleen is causing seizures? Lisa, I find that really hard to believe." Charlotte crossed her arms challenging the diagnosis.
"They believe it's a rare tropical disease, but they aren't sure which one. They're narrowing it down, but in the mean time, if they don't remove his spleen, it's just going to get worse." Cuddy took Charlotte by the arm and led her to the corner of the room. "I assigned Dr. Robert Chase to do the surgery. He's good, Charlotte, don't worry."
"Of course I'm worried!" She shouted, then winced when Jared moved slightly. Quietly, she continued, "He is an 8 year old boy. I know spleens aren't the most vital of vital organs, but removing it?"
"He has Spherocytosis. House said it was the best thing to do." Charlotte looked at her skeptically so she added, "And I agree. I'm sending Dr. Chase in a little later to talk to Jared about the surgery." She squeezed Charlotte's hand. "We're going to make him better."
"I didn't sign up for this," Charlotte laughed "I have degrees in cognitive studies and social intervention… not taking care of someone else's son."
"You're doing a good thing." Cuddy smiled and gave her hand another quick squeeze before leaving the room.
"Dr. Charlotte?" a little voice squeaked from the other side of the room
"Jared, you're awake." She rushed over to his bed
"What's a spleen?" He whispered, his brown eyes big, wide and completely trusting.
"Actually Jared," Another voice said from the doorway, "You have Spherocytosis." The man started walking towards the bed and Jared stiffened up immediately. "Do you like doughnuts, Jared?" Jared nodded, "Well, blood cells are shaped like jelly-filled doughnuts, but yours are shaped like baseballs and they're going through your spleen to get cleaned and they are getting caught in there," he pointed at Jared's stomach "Right here. So we're going to take out your spleen and get you better."
"Dr. Chase I presume?" Charlotte looked at him with a small smirk
"Yes, sorry." He reached across the bed and shook her hand. "And you must be Dr. Carrington, the genius behavioral therapist."
"Charlotte. I'm not a doctor today. Just a concerned legal guardian." She looked down at Jared. "Do you have any questions for Dr. Chase?"
Jared waved his hand, motioning Charlotte closer. He whispered something which made her laugh. She looked up at Chase with wide, sparkling eyes.
"He likes your accent. Where are you from?" She laughed
"Well Jared, I'm from Australia. I've heard you're quite the traveler yourself. Have you ever been there?" Chase grabbed the stool and rolled it next to the bed.
Jared tried to wave Charlotte close again, but she shook her head.
"You know the deal, Jared. I ask the first question, you do the second. If you can't ask him a question, then Dr. Chase and I will go outside and talk until you're ready to talk." Charlotte sat back down in her seat, sure in her method. After a minute, Jared opened his mouth.
"Fiji." He said softly.
"Fiji!" Chase smiled "That's better than Australia!" Jared responded by smiling back and reaching his hand out and touching Chase's arm.
"Tan." Jared stroked his arm softly, then immediately pulled his hand away. "Sorry."
"No, that's alright. I just got back from visiting from Australia. I spent a lot of time in the sun." Chase smiled again but Jared turned away. Confused, he turned and looked at Charlotte, who was leaning down reassuring Jared that he did a good job. When she finished, she looked up at him.
"Dr. Chase, can we talk out in the hall?" She stood up and Jared grabbed for her hand, but she slid out of his grasp and followed Chase out. "Thank you, Dr. Chase." She said once they got out into the hall. "He refuses to talk to anyone, so that was kind of a big deal in there."
"I thought you said you weren't a therapist today." He smirked "That was strangely a lot like therapy."
"I am what I am." She shrugged. "Dr. Chase, answer me honestly: do you think he has Spherocytosis?"
"He has a low hemoglobin count, he's slightly anemic, it all fits. It would even explain the nose bleeds." Chase thumbed through Jared's charts
"But the seizures. It doesn't explain those, does it?" She crossed her arms and stared him straight in the eyes.
"No, I guess it doesn't. I didn't know psychologists got such intensive medical training." He laughed
"No," She shrugged "But my dad was a doctor. Something must have sunk in."
"Look, his spleen isn't working and it needs to be removed. Maybe after we get rid of the symptoms of Spherocytosis we'll be able to figure out what is causing the seizures." He said apologetically
"Won't it just make him weaker?" She asked meekly
"Dr. Carrington, we can control the pain and we'll monitor him closely. It's all we can do for now." He looked at her softly "If you want, go talk to Dr. House. His office is-" She turned around and started running down the hall and pushed the button for the elevator. "Wait," Chase ran after her "Where are you going?"
"I have to tell him he's wrong." She said as the doors opened. Chase slipped in after her
"What?" He looked at her with disbelief
"He's wrong. He can't diagnose an 8 year old boy with a disease, that yeah, sure, it fits, but not completely." She shook her head. At that moment, the elevator opened and she tore down the hall with Chase on her heels.
"You're wrong." She burst into House's office. His team froze in the spot, eyes glued to the intruder.
"No…" House started slowly
"Ok, you're right, but you're wrong." She took a few steps closer
"You can't be right and wrong at the same time." He cocked his head to the side "Damn logic."
"He may very well have Spherocytosis. I'm not saying the diagnosis is wrong, but you're conveniently forgetting symptoms to make a diagnosis fit!" She walked over to the table and looked at House's team then turned around "Since when did you get lazy?"
House looked around at his team in disbelief. "It took a psychologist to figure it out?"
"Figure what out?" Taub looked at House then at Charlotte
"That I'm lazy!" House limped over to the board.
"Hey, if the behavior fits." Charlotte crossed her arms and looked at the table. "Have you even read my notes?"
"They've been busy reading blood tests and whatnot," He looked at Kutner "Except him. He's been busy reading the patient's horoscope." He leaned in, "The moon is in Sagittarius, not looking good for finances."
"Look, Dr. House," Charlotte spat out, "I am medically responsible for a little 8 year old boy and I will not having you remove his spleen if his problem isn't with his spleen."
"Who said the problem isn't his spleen?" House squared himself to look directly at Charlotte
"It doesn't fit." Charlotte insisted
"It partially fits," Dr. Chase suggested, "What if there is a problem with his blood, but not necessarily his spleen."
"Bruising." Thirteen spoke up. She was holding Charlotte's notes in her hands "September 2nd you reported he was grabbing his left arm and leaving dark bruises." House stood up straight and looked interested
"Leukemia." Foreman sat forward in his chair. "Acute myelogenous leukemia. It would explain the blood count, the weakness, nose bleeds…"
"Seizures?" Charlotte looked at House
"Present themselves in late stages of leukemia." He said softly
"So he's dying." She took a step back and looked at Dr. Chase. "You can't save him."
"You wanted an answer. You got one." House started into his office
"I'll start running more blood." Foreman stood up and started out the door
"I'll contact Wilson for a consult." Kutner made a hasty exit, quickly followed by Thirteen and Taub.
"Charlotte," Chase said softly "I'm sorry." Then he quickly left as well.
Charlotte looked across the room into House's office where he was seated with his back turned to the door.
"Do you really think it's leukemia?" She asked as she crossed into his office
"I have been wrong before." He said without turning around
"Leukemia is so…" She searched for the right word. "Pedestrian. I refuse to believe your team didn't see it right off the bat."
"Have you ever noticed anyone driving slower than you is an idiot and anyone driving faster than you is a maniac?" He kept his back to her, but she could see him twirling his cane
"You knew it was leukemia from when you first looked at his file." She shook her head "So why didn't you get your team to treat that first? Why did you wait three weeks and threaten a splenectomy when you could have been treating leukemia from day one!"
"I knew you wouldn't fall for the splenectomy." He laughed to himself. "He hasn't gotten worse in the last three weeks. If he was getting worse, my team would have spotted it." He still didn't turn around
"He wouldn't have been in pain!" Charlotte cried
"He would have been in pain from the treatment, in fact, he'd have been in more pain." House said coldly, "I did him a favor."
"Why did you do nothing for three weeks?" She asked again
"Because I didn't want you to have the responsibility of telling a little boy he was dying." House turned around and slammed his cane on the desk, causing Charlotte to jump. "If I could hold off long enough, his parents would come and you'd be free from your duties as POA. That boy is not your responsibility!"
"Yes, he is." Her eyes narrowed "He doesn't have anyone. I'm all he has. I'm who he trusts."
"Since when did someone needing you become the requirement for being responsible for that person?" House looked at her, his expression unreadable.
"I guess it never was." She shook her head and turned to walk out of the room.
*
Charlotte was standing at the nurse's station when Cuddy found her.
"You will not believe that all of my doctors are actually hanging out in the clinic. Willingly." Cuddy started, noticing Charlotte's glazed over expression. "However, they're too busy gossiping about how Dr. Carrington stood up to House to get any work done." Still no response. "Good news is he won't have to have his spleen removed." She offered weakly.
"Bad news is he's dying." Charlotte said in monotone.
"Not necessarily. We can get him healthy enough for a bone marrow transplant." Cuddy suggested.
"House said he was dying. Oddly, I trust him. Seizures only present themselves in the late stages of the cancer." She shook her head "If only I noticed the signs. If I hadn't been so involved in his behaviors. If I had noticed the boy underneath the disorders…"
"Charlotte, you can't do that to yourself." Cuddy put her hand on Charlotte's shoulder.
"I know." She looked at Cuddy and for the first time Cuddy saw that she had tears in her eyes. "When I get back to D.C. I'm handing in my letter of resignation. I have some friends who want to do a study on Community Rehab. They've gotten government funding and asked me to join them." She sighed, "Telling addicts that they're dying because they were stupid seems to be a lot easier right now than telling an innocent boy that he's dying for no fault of his own."
"Maybe you won't have to." Cuddy nodded to the elevator. Jared's parents were standing in front of closing doors, looking around. "I recognize the red hair." Beside her, Charlotte took in a deep breath. "You won't have to say anything, just be there to offer your support when they hear the news."
"Lisa, thank you." For the first time, Lisa saw the little girl she once knew. "Thank you for keeping my secret and thank you for doing what I can't do."
"That's what friends do, Charlotte. I'm not going to leave you standing here to face an uncertain future alone." Cuddy grabbed her hand and squeezed tightly. "Let's go bring them up to date."
*
There was a knock on Cuddy's office door and Charlotte peaked her head in.
"You wanted to see me?" Cuddy motioned for her to come in.
"You have your bags with you." She looked down at the suitcase in Charlotte's hand.
"I came by to see Jared before my flight leaves. His parents chose to go through with the treatment, even though the prognosis isn't the best…" Charlotte sighed. "But he's young and willing to fight, so he has that on his side."
"That and he's surrounded by people that love him." Cuddy stood up and walked around to the front of her desk and leaned on it. "I don't think you should leave just yet."
"I need to." Charlotte smiled. "I talked to my friends doing the Community Rehab research. If I want to join in on it, I need to be there by the end of this week. They're facing the Internal Review Board to get the go ahead."
"That's great!" Cuddy exclaimed. "Where will you be practicing?"
"Where ever I can find a rehab clinic willing to try a new program." She shrugged "I have sent a few emails and gotten back a few names."
"What about here? This is a teaching hospital." Cuddy asked slowly. Charlotte opened her mouth to speak, but abruptly closed it. Cuddy laughed as Charlotte pursed her lips and furrowed her eyebrows. "You always looked more like your father than your mother."
"Lisa," Charlotte sat down on the nearest chair "I don't think I can do that. Especially with Jared still here. So much of my past is here and I've been working really hard to avoid it."
"You won't have to work to avoid it. It'll be nice and natural to avoid things here. It's what we do, if you haven't noticed." Cuddy laughed again "Rehab is nowhere near the hospital. You can take the elevator on up and never leave. Plus, the director is leaving at the end of this month and I really think our program needs to be overhauled."
"And government funded?" Charlotte raised an eyebrow
"Yes, that would help…" Cuddy moved to the chair next to Charlotte. "Look, new programs like Community Rehab are just what we need to stay on top. If you come here, I can offer you a hefty raise, wonderful benefits and all the avoidance technique training you could ever use."
"Tempting." Charlotte sat back and studied Cuddy. "Why?"
"You graduated top of your class at Michigan, Oxford and NYU. You're smart, Charlotte. You're good at what you do. You have enough of your father in you to make you ruthless and enough of your mother to make you passionate. You, in my opinion, have the energy and the tenacity to make a difference and our rehab program has been suffering."
"Ok." She said simply and stood up. "Where do I sign?"
"That's it?" Cuddy looked at her in disbelief. "That's all it took?"
"When I was three, my dad called me tenacious. It took me most of the day, but I looked it up in the dictionary. I liked what it meant and I like what it said about me. Working in children's therapy, I forgot what that word meant." She shrugged "I want to like it again."
"I didn't think you said yes, so I don't have any paperwork ready." Cuddy walked around behind her desk again, looking through papers to try and find what she wanted.
"Well, I guess I'll just tell the IRB I'm tentatively scheduled to do my research at Princeton-Plainsboro Teaching Hospital." She reached out her hand for Cuddy to shake. Instead, Cuddy walked around the desk and clutched Charlotte close.
"Damn it, I missed you." She whispered softly as tears began to fall down Charlotte's cheek.
