Vicious Intent
Notes: Where were you? Some of you may be wondering. Well, to be precise, I was all over England on an exhausting business trip where I was wined, dined and handed a lot of documents. But it's all over now, and I'm back! And as a big sorry for the delay, here's a big fat chapter. Again, reviews are very much appreciated. (Long reviews are a great bonus for me, hint hint. I know, I'm so thick skinned, aren't I?)
Oh yeah, here's where the medical bits start coming in. Here's a big disclaimer: I'm not a doctor! So forgive me if I've made any mistakens. Just imagine yourself in another dimension where all these badly-researched medical stuff is true.
Disclaimers in Part 1
Chapter Four
"Let me guess. She was furious."
"Furious is another way of her saying that she's a sore loser," House answered.
"Sometimes your logic astounds me," Wilson dead panned.
They were outside Chase's room, watching him sleep while Dr Wong examined him. A nurse was busy mopping Chase's still sweaty brow - a scene which Wilson suspected that House was storing in his memory banks to use for future Chase-ribbing sessions.
Chase, to put it simply, looked like crap. Wilson was so shocked at how much he had deteriorated since the last time he saw him that this whole thing seemed surreal. Just yesterday, Chase was angrily swabbing peanut butter on a few slices of bread, looking bruised but otherwise healthy. Today, he looked like one of his cancer patients – only his patients usually took weeks to look like that, not mere hours.
Dr Wong began taking Chase's blood pressure. Wilson frowned when he saw the pulmonologist shake his head. Whatever the results were, Dr Wong didn't look pleased.
Wilson had long ceased to wonder why he and House were doing here or why the man was so very interested in Chase's condition that he'd try so hard to snatch away another doctor's patient. House shirked work so much that such an act was unheard of. Wilson had also given up trying to find out why House was so convinced Chase took drugs. House's leaps of logic were often mind boggling; this one was no different.
"You know what I think?" Wilson thought out loud.
House threw Wilson a furtive glance. "Thinking is not good at this time of the night. You'll get indigestion from straining your brain so hard."
"I think you're doing this because you feel guilty," he gave House a smug grin.
"Oh, right! That explains everything. Don't leave your day job, Dr Phil," House said scornfully.
"Then why the concern? Dr Wong is a great pulmonologist, not a doctor fresh out of medical school. So: You want to make up for that punch you gave Chase. You feel guilty," he said triumphantly.
"Am not. Take that back," House retorted.
Wilson chuckled.
House scoffed and said: "What I am concerned about is Dr Wong ignoring the obvious. Pulmonologist or not, he's not even running a tox screen."
"Ah. The tox screen. Again. I heard about this saying once. Something about a pot and a kettle," he said. How ironic, thought Wilson. Perhaps House was projecting, seeing his problems in Chase. Problem is, Chase probably didn't share the same problem.
"Funny, I don't get how the saying ties in with Dr Wong being a moron," House retorted.
Wilson sighed, then paused as realisation hit him. "Where is Foreman and Cameron?" he asked suspiciously.
"Taking tango lessons," he retorted.
"House. You did it, didn't you?"
"Well, technically, I'm not doing anything." House smiled. "Cameron and Foreman are doing it."
oOoOoOo
"So, this is Chase's apartment. For some reason, I expected something more sterile," Foreman remarked.
Chase had a small, serviceable studio near the hospital that had a bare kitchenette that looked as if it was barely used, a bed behind a stack of shelves housing an eclectic collection of medical textbooks and novels, and a tiny sitting area with a beat up TV that looked as if it was barely functioning. A well-used guitar leaned against an armchair. Foreman looked at it in fascination.
"He plays? Didn't take him for a creative type," he said in surprise.
"What are we even doing here?" Cameron thought out loud. "Why would House send us to check out his apartment when Chase only has pneumonia?"
"What, you've made up your mind about what he has already?"
"Do we have any reason at all to suspect it's anything but that?" Cameron shot back.
"He was high," he said, then shrugged.
"Like you said, he could've been drunk and have pneumonia."
"Only explaining how House thinks," said Foreman who shrugged as he picked up a photo frame sitting on the telephone table.
"Put that back," Cameron said tiredly as she went through Chase's fridge. Apparently, Chase didn't believe in stocking up his fridge. There was barely anything there except for a lonely, beyond-expiry-date apple and a carton of ... expired milk. She frowned.
"What? Am I not allowed to wonder who the woman with Chase is?" He showed her the photo. It was of a young, red-headed woman and a younger-looking Chase.
Cameron rolled her eyes. "I feel like enough of a creep already. Chase is lying in a hospital bed and we are invading his apartment, pawing through his stuff like a bunch of thieves. I'm sure you'd like that too if House did that to you," she said sarcastically.
She felt a rush of satisfaction when she saw a tinge of guilt on Foreman's face.
"He's going to be fine," he said, changing the subject abruptly. "Two out of three from House's department coming down with a strange, difficult-to-diagnose disease? That is a stretch." He laughed shortly at that. "Either that or it's getting to be plain bad luck hanging around House."
After the debacle in Chase's room, Cuddy had firmly told the diagnostician that he should butt out of other doctors' cases or else. House wasn't even supposed to be treating Chase and conveniently failed to inform them of the fact, which made Cuddy speechless with amazement.
Meanwhile, Chase's real doctor, Dr Wong, was more than a little furious when he found out that House caused his patient to nearly pass out from a near-brush with respiratory distress. But, House being House, ignored Cuddy's directive and told Cameron and Foreman to "check for his stash" in his apartment. Cameron found House's assumption of Chase's drug use irritating and more than a little hypocritical.
"I found expired milk. But as far as I know, expired milk doesn't cause pneumonia or any of his symptoms," she said, trying to distract herself from her moody thoughts.
"Bag it anyway," Foreman said distractedly.
"We're looking blind!" she said, shoving the milk carton into a bag none too gently. "What the hell are we looking for anyway? Chase is going to be so pissed when he finds out," Cameron grumbled under her breath.
"That we're going through his stuff or that we still don't believe that he's drug free?"
"Both," Cameron said, nearly growling.
"Face it. House is just doing this because he likes to torture Chase."
"As if the punch isn't enough?" Cameron remarked. "House doesn't do anything for no reason. He must suspect something."
"He also happens to be in a great need for diversion, thanks to Tritter. Chase is just a way for him to 'refocus'," Foreman said.
Cameron sighed again as she made her way to the sole bathroom in the studio. When she got to the doorway, it took her a while to process what she was seeing.
"Foreman!" she called out, taking a tentative step inside.
The neurologist was in the bathroom a few seconds later. His brow wrinkled in puzzlement when he saw the carnage before him.
The medicine cabinet was open. Medicine bottles were opened and multi-coloured pills lay scattered on the floor. Cameron picked a few bottles, studying the labels. They were mostly vitamins ... but what caught her attention was-
"It's fluoxetine," she said, her voice low. She gave Foreman a guilt-laced glance. She felt like she found out Chase's dirty little secret. Chase, who kept his life private to an almost paranoid degree, would never want anyone to find out about this.
Even Foreman was taken aback.
"Anti-depressants? Chase was taking anti-depressants?" Foreman asked in surprise, then frowned. He let that piece of information sink in before continuing: "There have been documented cases of fluoxetine users suffering from side effects such as sweating, fever, chills ... and there are rare cases where patients exhibited memory problems. It explains almost all his symptoms." A pause, then: "But they don't cause such a severe reaction like what Chase is having now ... at least not in documented cases."
Cameron stared at the bottle, then at the pills on the floor. "How much did he take?"
Foreman's frown deepened. "After taking the pills ... he went to the bar. Presumably to take whiskey. Alcohol and anti-depressants ..."
They exchanged a quiet look. They realised then that they found out more than they should comfortably know about their colleague.
OoooOooOo
"Dr House, you can't go in there! I'm going to call Dr Wong!" yelled a nurse.
That was the only warning Chase had before House marched into his room, together with a reluctant-looking Cameron and Foreman. Both looked chagrined for some reason. That made him nervous. He tried to sit up straighter – emphasis on tried – and ended up only a few inches up the reclining bed. Chase steeled himself and tried to meet House's amused/irritated glance as levelly as he could.
"You're not my doctor," he said as calmly as he could.
"True. But that doesn't mean anything to me. So, seen any good shrinks lately?"
Cameron flinched while Foreman sighed and crossed his arms, looking as if he didn't want to be part of this interrogation.
It took only a moment for Chase to piece together what House had done.
"You broke into my apartment," he said in horror.
"No. I told Cameron and Foreman to break into you apartment. And do you know what I think? You took a couple of pills, headed down to the bar to finish the job by downing some alcohol. Gee, Chase. I punched you, I didn't say I hate you," said House.
"House, stop," Cameron said.
"What, now you're calling me suicidal? I cannot believe this!" Chase said in disbelief and laughed bitterly, fighting the tide of humiliation and despair inside him. He coughed, then dragged a shuddering breath. "Believe me, House. You're not worth it. If I wanted to kill myself, I would at least make sure it's a reason worth bothering for," he rasped.
"Side effects of fluoxetine overdose may include fever, nausea, dizziness, confusion and in rare cases retrograde amnesia. Your mistake was not that you tried to off yourself, but for failing to inform Dr Wong about your drug usage. Neat trick, taking that off your medical history. You want to preserve your precious secret so much? Well congratulations if you end up on the coroner's table when he prescribes you a drug that will conflict with the fluoxetine!" he snapped.
"It's none of your business what I'm taking. And how ... dare you break into my apartment! I'm not even your patient," he hissed between exhausted breaths.
"I'm hurt. And I don't care. When did you start taking fluoxetine?" House pressed on.
Chase stared at Foreman then Cameron; he shook with helpless rage, which didn't help with the chills or the fever raging in his body. He forced himself to a sitting position with shaking arms.
"You think you know me so well," he whispered breathlessly, glaring at House hotly. "You don't know anything about me!" He shifted his glare to Cameron, then Foreman. "None of you do!" he snapped, his voice rising a notch in volume. But all that activity and shouting proved too much for him. He then collapsed on his side listlessly, coughing weakly. When it was all over, his breath came in tortured gasps; his chest rising and falling quickly with shallow, panting breaths.
He took another gasping breath, but that didn't help either. His eyes shot open in panic as yet another breath resulted in little oxygen intake. Spots began to dance before his eyes even as he took another long, desperate breath.
Then one of the machines began to shrill loudly and he panicked further.
"Respiratory distress!" he heard Foreman say above his desperate choking gasps for air.
Sounds faded, the world became a blur ...
And then, suddenly, he felt overwhelmingly weak ... and it didn't seem important anymore to struggle as numbness permeated his body. The last thing he saw before his eyes rolled up into his head was House peering down at him, his blue eyes so intense they seemed to glow.
Then nothing.
OoooOoOoo
House shoved Cameron aside, quickly grabbed the laryngoscope and an endotracheal tube from the nearby crash cart and pushed Chase onto his back. Expertly, he tilted the man's head, and intubated him, and removed the stylet. Cameron passed him an ambu bag, which he quickly connected.
He pumped the bag rhythmically and they watched as Chase's pale and slack features slowly lose its bluish hue. But it seemed like a long time before the monitors stopped shrieking and they were left with the rhythmic sounds of the heart monitor and the whoosh sounds of the pump.
"Hook him up to a ventilator," he told a shell-shocked Cameron. The immunologist quickly blinked away the film of tears on her eyes and rushed out of the room, casting a last look at Chase's limp body before she went out the door.
Foreman was by then listening to Chase's chest with a stethoscope. When he looked up a moment later, concern was etched on his features.
"There's fluid in his lungs. He has pulmonary oedema," he said.
House returned his gaze to Chase's pallid features, the livid bruise on his jaw the only colour on his face.
"This is more than a fluoxetine overdose," he muttered.
OoooOooOo
"What the hell were you thinking?!"
That remark, shouted out so loudly that patients and nurses down the corridor paused to look at the source, echoed around Cuddy's office. Cuddy, however, was not the source of the roar but one Dr Jensen Wong. Cuddy sighed and walked to her office door and closed it.
"How can you tolerate this, Dr Cuddy? He's gone too far this time! This time, he has stressed my patient so much that he has gone into respiratory arrest. What next? A heart attack?" he yelled.
"Stress doesn't cause pulmonory oedema, you moron," House shot back. "Transfer Chase to my care," he demanded of Cuddy.
Cuddy could barely reign in her snort of disbelief, but Dr Wong voiced it for her.
"What? Now you're calling me incompetent?" he yelled, his face now red from fury.
"Gee, it's not always about you, you idiot. Confusion, fever, memory loss, dyspnae, and now pumonary oedema – does that sound like garden variety pneumonia to you? Or even your average attempt at suicide? Transfer Chase to me, or else he dies," he snapped. "Oh, no offense to your abilities, of course, Dr Wong."
Cuddy placed a weary hand to her aching head and sighed.
House continued: "We need to run a tox screen to rule out fluoxetine and other drugs; thankfully it's not drug overdose, which I doubt he had or else he'd be dead thanks to the speed of the treatment he's getting, but Dr Bright Idea here thinks it's just pneumonia."
"Pulmonary oedema is simply another symptom of pneumonia. We don't have any reason to believe that he doesn't have pneumonia!" Dr Wong snapped.
Cuddy gave up. She raised her hands and snapped: "All right! Calm down, everyone! House, there is no reason why Dr Wong can't handle Chase's case. And he is right, Chase has classic symptoms for pneumonia – I can't just allow you to order a tox screen just because you feel you're right."
"Feel I'm right? I know I am right-"
"You're not infallible, House," snapped Cuddy.
"Is everyone sleeping on the job or am I the only who noticed that Chase went from bright, sunny, and able to take a punch and still jump up, twelve hours ago, to this limp sack of sweating meat now? Whatever he has is progressing at warp speed, and the longer we think that it's just pneumonia the less likely it will be for us to catch this thing in time!" he snapped.
Cuddy refrained from chewing her lip as she tried to make a decision. She hated to admit it, but she knew that House was right. Again. The symptoms seemed to suggest just pneumonia, but the pneumonia – especially the speed at which it developed - could be indicative of something far more serious. And she knew that for Chase's sake, House was the right person for the job. Only he could "outdiagnose a speeding bullet," to quote Wilson.
After agonising seconds passed, she nodded stiffly and then sighed. "Okay. Fine. I'm sorry, Dr Wong but-"
Dr Wong merely shook his head and stormed out of the room in a fury. She felt herself wilt inside at the thought of placating another furious doctor. She lost count of how many times she had to calm furious doctors in this hospital. She gave House an icy glare.
"I hope you're happy, House. And I hope it's not for nothing," she snapped.
"Oh, I'm happy. I won a bet with Wilson," he said. With a satisfied smile, he left.
Cuddy could only sigh.