A/N-Thanks to all who favorited and followed, and to all of you who left comments: BabalooBlue, IHeartHouseCuddy, chebelle, Suzieqlondon, jaybe61, LapizSilkwood, JLCH, bere, ikissedtheLaurie, OldSFfan, lenasti16, ammeboss, CacauHousemaniaca, MrsBock, precioussoulandsweetcheeksiin1, MonFogel, Melanie1121, vicpei1, Abby, CaptainK8, freeasabird14, Ann, HuddyGirl, byte size, Alex, Boo's House, LizLo, LoveMyHouse, KiwiClare, aussiefan12, Jane Q. Doe, Little Greg and grouchysnarky. (Thanks also to all of those who still gave the thumbs up to Apollo). I'm trying to put out at least 2 updates a week on this story.
Also, I did not become a doctor since the last time I wrote something medical-related, so I'll apologize in advance for anything I may have messed up. This is based on some research and a little bit of knowledge, but I'm still not an expert in anything in the field of medicine. I tried to do enough research to make it realistic.
-Arrangements-
House's mind burned from the heat of stunned confusion while he watched the woman in the recliner begin to wake up. When Arlene saw him turn back to look for answers, his eyes were wide, his face was pale, but his ears and neck were flushed red. His hand clenched onto the handle of his cane with a death grip, and he asked the only question that he could, "Where's the file?"
"Oh my god," Cuddy's shaky voice came through, muted, with less force behind it than normal, but with instantaneous rage. "You did this?" she asked her mother, pointing at House. "I said no. I said no. Why? Why is he here?"
House turned back to the woman he had once known almost everything about and stared for a few moments. Cuddy was jaundiced and impossibly thin, with shorter curls jutting out from under a bandana that was folded and tied over her head. Her grey stare seemed to be the most familiar part of her, and even it was offset by the yellowing of the whites of her eyes.
When her angry gaze met his, he looked away for a moment, trying to disguise the sense of numbness and outright shock at her deteriorated condition. He had a few seconds to recoup, to summon his strength, and then he looked back at her, "What in the hell happened to you?"
Cuddy held one hand out, fingers spread wide, a few inches in front of her face, an attempt to prevent him from looking at her that was largely in vain. She angrily asked her mother, "What part of 'do not call House' was in any way unclear to you? How was that open to any other interpretation?"
"It doesn't hurt to have him look," Arlene answered, walking toward her daughter, "he's already here. It's like you want to die."
Arlene's words rang in his ears as he looked between the women silently, still too disoriented for a bigger reaction. He barely cleared his throat and asked, "File?"
Cuddy looked past Arlene right at House, "This is of absolutely no interest to you, believe me. I have a diagnosis. There is no puzzle, no mystery, no hidden cure for a little known disease. There is me and cancer, and two-to-four more months of misery until I die. My case is your textbook definition of boring. Curiosity satisfied?"
His eyes locked on hers, more determined instead of less, "File," he ordered as he held out his hand, palm facing upward, still focusing on the only response that made sense to him.
"Tell him," Arlene added in, ignoring House and arguing with her daughter, "tell him that you refused treatment, you refused chemo, and you won't even let them take it out."
"Somebody give me the fucking file!" he yelled so loudly that both women jerked their heads to face him, a bit startled.
"I'll get all of the paperwork," Arlene offered before she left the room.
When Arlene left, they were there, just the two of them, enshrouded in silence and the cold chill of their complicated past. It was one of the most awkward and unforeseen meetings in either of their lives.
"She shouldn't have called you," Cuddy began, "and you shouldn't have come."
"Oh, believe me," he countered with a defensively aggressive scoff, "if I would have known whose case it was, I wouldn't be here. I didn't know it was you."
"It's good that we've established that. Since I don't want to see you…and you don't want to see me…leave." Her voice quivered a bit, her eyes were sad and weary in a way that sucked the power out of her stare. She was a shell of the woman she had been.
He squinted tightly at her, considering a hurtful response or an almost comically chipper farewell, but as much as he tried to summon the most derisive and cold attributes of his personality, they were failing him when he needed them. He opened his mouth to push back, to make her feel some of the loneliness and pain that he had felt over the last couple of years, to help her taste the bitter thing that his life had become. Like her, he seemed to lack the strength and will to lash out strongly, like he was going through the motions of hating her.
He stepped closer, tilting his head, "You think it's cancer?"
"I know it's cancer," she nodded, putting out a hand to suggest that he cease his approach.
Ignoring her suggestion, he walked closer, "You refused chemo? Surgery? You aren't Wilsoning out of treatment, are you?"
"I've done all of that. I'm not doing it anymore. This has been my world for a while."
He used his cane to pull a hassock away from the chair where Arlene had been reading and dragged it over to Cuddy's recliner. Sitting cautiously, stretching and rubbing his leg, he mentioned, softly, "If your body isn't responding to treatment, maybe it isn't cancer."
"It's cancer, House," she answered, her voice still making attempts at harshness but her body language the slightest bit less protective. "A year ago I was diagnosed with stage II endometrial cancer. With a history of infertility and my age, no successful pregnancies…I'll just say there were enough risk factors…I wasn't shocked."
"Stage II? What's the big deal?"
"Thanks for your compassion and understanding."
"I'm just saying…treatable. If it isn't responding, then maybe there's something else going on. So, how did they treat?"
"Very aggressively. Berger at Mass General. I rented an apartment in Boston for Mom, Rachel and I so I could be treated. I told Berger I wasn't going to die. She agreed. We went all out, radical surgery, I told her to cut out anything that even had thoughts of becoming cancerous. I wanted the cancer out. I wanted chemo, I tried to talk her into IP chemo, which she said wasn't necessary, but I fought. I fought with everything that I had. After surgery and six months of chemo, everything looked good. Everyone told me, 'Chemo isn't as bad as what it used to be, some people don't even have a problem with it.' I had a problem with it. I was sick…so sick, after each treatment. My daughter doesn't know how to multiply yet, but she knows how to take care of me during the first few days after a treatment. She knows what a port is. She knows how to read the labels on my bottles enough to find whatever I need. I told myself it was worth it. I told myself and Mom and every single person at the hospital who would listen that it was worth it. I was investing six months of my life to own the next…what…twenty or thirty years? I would have been happy with ten more years. I was paying my dues so I could see Rachel grow up…so I could be there for her. So she didn't have to be abandoned…again. So my mom didn't have to outlive her daughter. After a life full of healthy habits and exercise, if anyone was going to survive, it was going to be me," Cuddy choked out, trying to hide the sadness in her voice and blink away the tears in her eyes.
"I told you to eat more hamburgers," House teased in a strangely gentle way that sounded soothing in spite of the words that were spoken.
She breathed a subtle laugh through her nose, "You did. Look at you. You're going to outlive Wilson and I. Of the three of us, who would have thought that you'd be the last one standing. You're the oldest, been closer to death more times than Wilson and I put together. You never gave a shit about what you did to your body. More Vicodin has been through you than all of the other Plainsboro employees combined."
"I tried to do my part. What am I missing? You said treatment went well. But you're here and you're really yellow and really frail. So…the cancer is back? Liver?"
"Pancreatic," she laughed sadly, "and given the size of the mass, and how quickly it appeared, I have two-to-four months left. That's it. Not two-to-four good months…months like this…like I am now, and then worse. I've had three months of this already. I'm done."
She heard him breathe when she said 'pancreatic,' but he was insistent, "Where's the old bitch with the file?"
"House," Cuddy said firmly, "let it go. Go have fun for Wilson and me. You and I have better things to do than waste each other's time and stir up the past. Unless you're still here because you want one more chance to try to kill me, because if that's it, by all means, give it your best shot. I'll hold still."
"Fuck that, Cuddy," he said, their fragile accord crumbling to pieces almost instantly around them, "You know I didn't want to kill you."
"Do I? Do I really know that? Because it seems to me-"
"You just don't want my help," he interrupted. "You want to keep on hating me and if I help you it makes it harder. So you're going to try to piss me off."
"You're right, how completely irrational of me to be angry after you tried to kill me."
"I wasn't trying to kill you. If you want to be angry at anyone, be angry at the person who is actually trying to kill you…and that is you."
"You think that because you sit and listen to me for a few minutes and you want to find a cure that I should overlook what you did?" she asked directly.
"You think that I should overlook what you did because of what I did?"
"Of course…I got what was coming to me, right?" she tried to yell, sitting forward.
The woman who greeted House at the door came in, turning on brighter lights in the room, "Is everything OK, Dr. Cuddy?"
"Yea," Cuddy answered, "I'm fine, Lily. My friend here is just leaving."
"I'm not actually leaving," House said to the young woman.
Lily, a nurse, walked over to check the IV, turning the controls away from her patient while she worked. "I'll be back in a little while."
Cuddy faced away from him after the nurse left, her expression rigid and stoic, "Goodbye, House."
He got up slowly, "You're such a coward."
"Excuse me?" she fired back, standing to confront him, "I'm a coward?"
His mouth gaped again, as he saw more of her, as he saw how frail she was, and the way her clavicle jutted out so far that her old self would have looked sort of chubby standing next to her. "Jesus, Cuddy," he said, shaking his head.
He tried to regain control, but it was too late, she saw his weakness, what was worse was, he felt his weakness. Her own expression softened as she saw the empathy in his eyes in spite of all that had happened between them, and she knew how bad things were. "Please don't look at me like that," she asked, her lip shaking.
"Like what?" he questioned, trying to find his nonchalance.
"Like I'm already dead."
He swallowed, rubbing a hand roughly along his stubbled jaw and wishing that he could feel the abrasiveness, that he could feel anything besides his own pained astonishment. "I'm not…," he started, taking the slightest step closer and trying to convince her, "let me look at your file. We don't even have to get along, we probably shouldn't even speak. But let me look. I want to know that you can't do anything, those other doctors are idiots. And I can't take the pressure of living for all of us unless I know that you have to die," he tried to joke. She took a few tired steps toward a computer on a table, but he limped past her quickly and said, "I can get it. You've out-crippled me."
"I'm fine," she argued immediately, but started back to the chair, leaving him to get the laptop.
When they were seated, she showed him the scans she received via email. She watched for his reaction while his eyes followed the image, the slightest tense worry appearing in his brow until the expression disappeared from his face again. He finally looked back at her and said simply, "Can't miss that."
"It's huge," she commented.
"Huge is relative."
"For a pancreatic tumor…"
"Yea," he admitted, "it's…pretty fucking big."
Arlene came in with the file and House pulled it from her, "I would have removed her tumor myself if I would have known how long it was going to take to get the file."
"What do you think?" Arlene asked impatiently when she saw they were looking at the scans.
House opened the file and began looking through what was there. "I'm not an oncologist but…," he began before he started tossing papers to the side in search of something. "Where's the newer stuff, recent blood work? The newest lab in here is from months ago. Where are the biopsy results?"
"She's refusing all treatment," Arlene accused.
"That's not treatment, that's testing. Where is it?"
Arlene pointed at Cuddy, "Ask her."
"I'm done," Cuddy answered calmly. "I'm done letting them unzip my body and dig around in it. I'm definitely done with the chemo and the sickness. There's nothing to fight here, this is a battle that I will not win. So right now, the only thing I can do is extend the suffering, not just for me, but for Rachel and Mom too."
"Oh, please," Arlene countered, before turning to House, "You see? You see how she is? This is not my daughter."
House watched Arlene out of the corner of his eye before looking back at Cuddy, "It's not uncommon for patients who have been sick to suffer from depression."
"Cancer patients," Cuddy interjected, "but it doesn't change the fact that I'm not going to beat this. This scan shows more than a tumor. My liver and surrounding lymph nodes are clearly inflamed. It has probably spread already."
He watched Cuddy while her nails scratched at her skin, some places along her neck and the exposed parts of her arms had angry, red scratch marks. Cuddy, somewhat hesitantly, left the two alone while she went to the bathroom, dragging her IV pole with her.
"Why does she scratch like that?" Arlene asked, "is that a sign of some other disease? Or maybe the depression, is that a…symptom? She was never like this the first time she fought cancer."
"It's the bilirubin. The mass blocks the bile duct and the bilirubin builds up in her blood stream. It's why she's yellow and why she itches. Her pancreas and liver are contributing to the itching, the tiredness, the lack of appetite and the depression."
"So what do you think? Is it cancer?"
"There are a couple of possibilities…but it looks like cancer. Without testing or a chance to treat, I can't confirm anything. When's the last time she ate? Is the nausea that bad?" House asked, his concern and curiosity overriding the typical irritation he usually exhibited when dealing with the old woman.
"I haven't seen her eat anything in weeks. Some broth here and there, liquids and they have her on the IV, but she hasn't eaten an actual meal."
"And the nausea, does she get sick as soon as she eats? The last time you remember her eating."
"Not really. Her nausea was mild compared to when she was on chemo. She just doesn't like to eat."
"Eating would help. It's hard to tell how much the weight loss and fatigue are the result of her condition and how much they're the result of not eating. So when did the hunger strike begin?"
"I don't know. She lost a lot of weight during her chemo because she was so sick. She started doing better after the chemo ended, but she didn't have a chance to get completely back to normal before she starting feeling bad again. When it started, when the pain in her back began and the jaundice set in with the nausea, she gave up…even before the scans showed her something was there."
"Did you try to talk her into a biopsy? They could put in a stent to relieve her symptoms, then maybe she could eat, she would feel better. If she felt better, maybe she would start using her brain again."
"You think she could survive this?" Arlene asked without masking her maternal worry in the least.
"There's a chance, but not if she won't let me do anything. There is no chance if she just wants to sit there and wait for death."
"She isn't herself. If she could act like herself, she would fight it. She would try."
House sat back in the chair, leaning his head against his hand, the knuckles of his fist pressed against his tightly sealed lips. Arlene stood in front of him, arms folded, and said, "The truth is…that my daughter wants to die. I need you to convince her to fight. Figure out why she isn't herself."
"And if I can't convince her?"
"Find a way to run the tests or do the treatment without convincing her," Arlene answered as if the solution was the most simple thing they could consider.
"I think shoving needles into people against their will is considered assault in some circles."
"So?"
"So? You're asking me to assault your daughter?"
"You've done it before."
House huffed, "No, I didn't. I assaulted her property. Not her."
"Same thing."
"It's really not."
"We're never going to reach an agreement on the past. So let's agree that I wouldn't consider this assault. I'd consider this…lifesaving, rescuing her from her own stupidity."
"The itching and depression could come from morphine too," he said as a thought distracted him, "She requested palliative care, so they have her on morphine, right? I saw something in the chart."
"Should she cut back on the morphine?"
"No," he answered while he was clearly working a problem through in his head as he rolled his cane between his palms, "the morphine could be helpful."
"Do whatever you have to do. I'm not going to lose my daughter."
"I don't want to go back to jail. Not for anyone…definitely not for her."
"I'll take your side. Our word against hers."
Their conversation stopped when Cuddy return to the room. Arlene left and they were there alone again. "You'd feel better if you tried eating," he suggested. Pointing at her IV, he asked, "Are you hitting the button a lot?"
"I haven't taken much of it yet, I hate the way it makes me feel."
He looked at her, studying her again with the brighter lights on in the room. "You look different."
"I'm dying, House. Sorry if that's ruining my figure for you."
"It isn't just that."
"Oh good, so now you're gonna treat me to jokes about the new color of my skin, I can't wait."
"It isn't that either. And, fine, part of it is definitely how thin you are. Emaciated is not a robust look on you."
"I'm not emaciated."
"You are. We could probably put you in the corner of a classroom and use you for the skeleton."
"Your warmth overwhelms me."
"You don't need warmth. You need truth. I think you're depressed…understandable…if you ate, you would feel a little better, you can build your strength so your body can fight. It might even help with the depression a little. Then we can get a biopsy and some blood work so we know what is really going on."
"No. You want to know what you can do?"
He stared at her suspiciously, waiting, and then shook his head when he guessed about the nature of her request, "Don't ask me to kill you."
"You aren't against euthanasia."
"Medically, professionally, no I'm not. I'm against it for you right now."
"You want me to suffer?"
Looking up, his eyes as pained as the night she ended their relationship, he stated firmly, "I can't end your life. I'm asking you… to not ask me."
Her response was lost and confused, but she nodded, "I won't ask you."
A pall of relief crossed over him, "Good. Besides, I won't do it for anyone who refuses some simple blood work and a biopsy. Before you've decided you're going to die…you should make sure of what you're dealing with."
"It's obvious."
"Assumptions are dangerous. Believe me, dying prematurely is a huge pain in the ass."
"There is something else you can do," Cuddy began.
"What?"
She looked at her IV pump, nodding her head toward it, "They know I'm watching…when they punch in the security code. Mom warned my nurse. I want the code. Will you get it for me?"
"That sounds very similar to you asking me to kill you. You want me to pretend like you aren't going to use that information so you can overdose on morphine?"
"I'm just asking for numbers. What I choose to do with those numbers is entirely up to me. You would be blameless."
"I could go back to prison. Forever."
"You won't. I want to spend the rest of today and tonight with Rachel so I can enjoy a last day with my child. She doesn't deserve to watch this again. She's been through so much, and watching me slowly die will destroy her. This is merciful for her too. Tomorrow morning, come back. I'll tell Lily I'm having more pain, ask her to increase the allowable dosage of morphine. When she punches in the code to change the settings, you can get the numbers."
"I just got out of jail Wednesday and I'm guessing this is a pretty big violation of my somewhat informal parole. This doesn't seem a bit extreme to you? You won't let me do a biopsy and run some blood work first?"
"I'm not asking you to kill me. I'm asking for the code. After you give me the code, I'll send Mom and Rachel away for a few days so Rach doesn't see any of this. Lily will see you leave and not come back. The following day, long after you're gone…so you can't be implicated at all…I'll do it. There will be a witness that you were not here. Rachel won't get hurt, Mom won't get hurt, and you won't be implicated."
"You think my resistance is about me being implicated?"
"I can understand not wanting to go back to jail. Please, all I want is the code," she pleaded.
He nodded, stood up and said, "I'll do it. I'll be back tomorrow. I should go get fucked and fucked-up one more time…just in case this goes wrong and I never see the sun again."
"I won't let that happen, House. You have my word, I will not let this come back on you. I'll wait two or three days after you go if that would make you feel better."
"If it makes me feel better?"
"Yea, if it will help you feel less concerned about going back to prison."
He went to the door, pausing to turn around, "You can wait two hours or two weeks after I leave, and no amount of time is going to make it all better."
"House," she sighed, "This is my decision. I know when it's time to let go."
Right before he left the room, he said with purposeful clarity, "I remember, I've had a first hand demonstration of how good you are at letting go."
Before the words even settled fully in her mind, he was gone.