a/n: Sorry for the slow update, but the snow that has struck my home state of Ohio has sucked my will to live, or at least my will to write. I hope that others out there buried in snow are coping better than I am. At least I managed to get this chapter out today. Happy reading!

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Chapter 4 – Digging for Theories

"I paged you over an hour ago." Randall was feeling rather uptight. It was likely the fatigue talking, but he was a little frustrated as well by the slow response.

"Sorry, I was in the middle of something. I got here as soon as I could." Chase always heard that one from House and never minded it, so he figured it would work for him.

"She's still unconscious. Her fever is at 103 and I started the tetracycline."

Chase started to examine the patient. There were a few new curiosities. "Her abdomen is pretty stiff. Any bowel movements?"

"None recorded as of late."

"We should do a colonoscopy." Chase opened the chart and examined all the latest data. "Damn, iGa levels normal. I suppose that was to be expected."

"Yep, it isn't CVID."

Chase continued his routine examination by getting out his light pen, opening the patient's eyes and gazing inward. His face told the tale of surprise as he checked again to be absolutely sure. He stared at his intern with shock, who was by now alerted to the abnormal findings. "Randall, she's in a coma."

"She is? The doctor on call when he checked her said she was just unconscious."

"Not anymore." Chase turned off the light pen and thought about the next course of action as he placed it in his pocket. "We need to get her into an MRI now. We should have no problem getting in at this hour. I'll get something arranged."

Randall nodded as he took his place next to the woman who he had immersed himself in her care. He remembered his training as to how coma patients could hear voices sometimes. He started telling her about the thrill of working in a hospital.

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"You sent Randall to talk to House?" Foreman laughed, picturing Chase sending the young one out to slaughter. "Man is that cruel."

"He now has to call him Emperor." Chase said laughing in return. "Besides, isn't that exactly what House used to do to us?"

"What send his minions to do his dirty work? Sure, which is why I would've thought you wouldn't do it. What goes around comes around I guess. I remember the title thing. He stopped asking me to call him 'Boss' when I made it clear I could kick his ass."

"My favorite nickname was Cameron's. I loved how she had to call him 'Master'."

Foreman looked across the room noticing the MRI results on the light board. "This from your patient?"

"Yeah. The tetracycline is only mildly helping. It is keeping her fever down to 100. The MRI really didn't show us anything."

Foreman headed over to the board and studied the scan with intense fascination, all while ideas of what could be happening sparked in his head.

"So, you actually want in on this?" Chase said smiling. "I knew you couldn't stay away too long."

"This isn't a very bad case of encephalitis. It isn't the kind that should be causing comas. You might be dealing with another infection somewhere."

"Something other than toxoplasmosis?"

"The parasite wouldn't do this either."

"Her abdomen was a little stiff. I have a CT scan and a colonoscopy scheduled in an hour."

"That's a start. Kidney, liver, pancreatic function normal?"

"Yep." Chase then froze as a revelation hit him. "She was taking folic acid. I'm willing to bet it was for PMS. I'll scan the uterus while I'm at it."

Randall walked in feeling the buzz of energy in the room. "Wow, you two look like you are brainstorming."

"Sorry Randall, looks like you missed it." Chase's pager started to beep. "Damn, there's an issue with the CT scan schedule. I better take care of this." Chase left Randall and Foreman in the room alone.

Randall looked in fascination as Foreman's eyes stayed fixed on the MRI scans. "Is there something there we didn't see?"

"Not really, it just seems curious that she is having all these problems and the scan for the most part is pretty clean." Foreman turned to face Randall. "So, how is it going with Dr. Chase?"

"I'm learning a lot. He seems to be interested in showing me things. Sure, the lessons have been rough, but I'm sure it was the same for all of you."

Foreman chuckled. "You got that right. This is one of the toughest programs you could be part of, but damn will it look good on a resume when you are done."

"Why do you think Dr. Chase stayed with Dr. House while you and Dr. Cameron left?"

Foreman folded his arms and showed interest in the inquisitive nature of this young man. "Wow, you like to ask the tough questions. Curiosity in an intern is good. Chase has a mind for diagnosis that Cameron and I don't have and never will have. He was meant to do this, and he is great with pressure, which means he can handle anything House throws at him, which is plenty. He was the first person to survive a full fellowship with House."

"Speaking of Dr. Cameron," Randall stopped there, wondering if he should ask the question.

"Yes, is there something you want to know about her?"

"Does she and Dr. Chase have a history? The way they carry on it seems to go beyond professional boundaries."

"You are very observant. By 'history' do you mean did they do it, the answer is yes."

"That explains a lot of things."

Foreman chuckled. "Yeah, well be glad you weren't around to be in the middle of the carnage. I was glad it was only a couple isolated incidents."

"I'm hoping for the day when there will be other people on the team that I can interact with. I've heard legendary stories about your diagnosis sessions."

Foreman now laughed at this kid's optimism. "Yeah, well don't believe all the mystique. It was mainly House berating us into accepting his logic. We always challenged him, but he always won out."

"It makes you wonder given his track record why he even needs a team."

"Somebody has to talk with the patients and do all the boring stuff. You actually get to do the work that unravels the mysteries. That's a huge responsibility on this team, so feel honored that you have it."

Randall wholeheartedly agreed. "Oh, I certainly wouldn't trade this opportunity for everything."

Foreman patted him on the shoulder as he went to leave. "Good attitude. Keep it up, because you'll need it once House is back."

Randall took in a deep breath after Foreman cleared the room. He felt in over his head most of the time, but he also felt like the luckiest intern alive.

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"Why Dr. Chase, you finally had that sex change operation that I always predicted would happen."

"Cut it out House, you're lucky I'm here at all." Cameron wasn't about to put up with his crap today.

"So Chase has resorted to sending his proxies? I must admit the intern would have been more fun to rattle."

"I have a heart. I couldn't put that kid through that again even if Chase had no problem doing it. I volunteered."

"So the nice Dr. Cameron decided to show up today. How sweet. You going to tuck me into bed when this is all done and make it all better?"

Cameron's biting glare indicated the obvious answer on that one. "What do you want House?"

"So now that the patient has encephalitis, what are you doing?"

"How did, of course, you are either guessing or you got inside info. Either way, what do you need me for? You shouldn't be thinking about the case. Chase has it under control."

"My guess is Chase started tetracycline or some similar antibiotic. Since that is now meeting with marginal success, where are you looking next? The kidneys, the liver?"

Cameron let out a deep sigh. She had just better answer his questions. "They are fine. The theory is that there is another infection somewhere that is causing all to go wrong. Chase is doing a CT scan of the abdomen next since there is abdominal swelling."

"Is he checking the spleen?"

"There is no evidence of lymphatic abnormalities and the area around the spleen seems normal."

"That doesn't mean that it isn't malfunctioning." House paused, then shook it off. "It doesn't matter, because I don't think that is causing the problem anyway. The absence of endocarditis wouldn't completely support this theory, but it is possible that she is currently predisposed to Septicaemia."

"Blood poisoning?" Cameron thought through the suggestion. "White cell count is normal and we haven't found any bacteria in her blood cultures."

"It isn't an ideal fit, but sepsis can be a cause. The blood cultures likely haven't found the right bacteria."

"So how do you suggest we diagnose or treat it?"

"Early Goal Directed Therapy. Just get rid of whatever it is. Central venous saturation would do the trick."

Cameron wasn't buying into such a reckless solution, as usual. "That is most effective in cases of severe septic shock. She isn't close to experiencing multiple organ failure. That is too radical at this point."

"It still works and it would flush out any blood infections that exist."

"If they exist. There is no evidence of blood infection and like you said there is no endocarditis. Such an intense procedure shouldn't be done without proper confirmation." House looked at her with complete resolve. "Why do I sound like a broken record? There is no way I'm going to convince you otherwise."

"Rerun the blood cultures if you must to test for a wider spectrum of aerobic and anaerobic organisms. Then when she crashes while you are doing that…now I'm the one sounding like a broken record. We know the drill by now. You try it, it either works or it doesn't."

Cameron stood up. "Luckily it's not your call. Chase isn't going to like this one bit but I'll still send your recommendation."

"Tell Chase he should be a man and deliver his objections personally. This will not bode well for him later if he keeps ignoring me."

"Yeah, I'm sure Chase is just quaking while you send your high and mighty orders from rehab. He's not caving into your pressure. You don't scare him and haven't given him any reason to believe in you these days. Still, I'll deliver the message." Cameron marched out of the room, leaving a quiet House to ponder at what point the dynamic so drastically shifted with his team. Maybe he trained them too well.

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"You've got to be kidding me!" No, Chase didn't take it well. "I shouldn't be surprised. Reckless theories are exactly what I should have been expecting. Good thing I have the ability to blow them off this time."

"What do you think about the sepsis theory?"

"Aside from the fact that all our tests cannot confirm it? EGDT is something used by the ICU in cases of severe septic shock. We aren't even close to that point. Although, it would certainly get rid of whatever infection she has if it is blood based, but I'm not convinced it is."

"She isn't experiencing organ failure yet, but she is having inflammation responses and is hypotensive. Septic shock could be what happens next."

Chase couldn't completely dismiss what was being suggested, especially since he didn't have any better ideas right now. "I suppose we can put her through some coagulation tests and expand the blood cultures for more types of bacteria. If those are abnormal I'll consider House's radical theory. I'm not putting her through EGDT though unless we need to."

Cameron nodded, but readied herself for bringing up one more piece of unfinished business. "Chase, he really wants to see you. Please, just humor him. He is going to make us all miserable unless you do so."

"What good will that do? He is just going to undermine my abilities as a doctor and decision maker on this case. I don't trust him right now. I have way too much to juggle here where I don't have time to humor the great Dr. House. I'll talk to him again when he decides to be a real doctor again."

Chase walked away, leaving Cameron a strong glimpse of the hard feelings Chase was harboring right now. She had no idea how badly House's latest mess caused a rift with Chase until now. She understood why he wouldn't seem him, but Chase's attitude was not going to be addressed by House lightly. The escalation could only get worse.

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"Randall, we are going to run through a series of coagulation tests. Have you ever done those before?"

"Coagulation? You think she is having trouble with blood clotting?"

"No, I don't. We are just trying to prove that her blood flow isn't causing tissue death somewhere which would be causing an infection. We also need to expand the blood cultures for a wider range of organisms to rule out sepsis."

"That could take weeks."

Chase smiled. "Exactly. You will learn though that through deductive reasoning we try to narrow it down to the most likely sources. It will still be a tedious several hours or days. Good thing I have someone reliable to handle all that for me." Chase gave him a pat on the back.

"I suppose this was something you, Drs. Cameron and Foreman had to do a lot of."

"You don't know that half of it. I think half of my fellowship was spent in the lab."

"Can't I at least get some help?"

"I'll see if Dr. Cameron has some time, otherwise we only have you. Unless you know of another intern who likes looking at blood cultures."

Randall shook his head, accepting that he was on his own. "You really think her issues are in the blood?"

"No, but ruling out possibilities is just as important. We have to be sure. This is a task you are more than ready for. Just call me if you find anything."

Randall gave him a blank stare. He then realized again that this was his boss and he better show some cooperation. "Okay, got it."

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Chase sat in the chair next to his patient as she peacefully lingered. This was the first quiet moment he had all day, maybe all week. The reminders of when he was just a simple ICU specialist were thick. There were many times when the shifts were this peaceful. He and the patients would share this quiet state of limbo, both knowing that at any minute the status could change, but at least they were able to experience the brief calm together before the moment of truth. Too often that moment of truth ended for the worse, but there were always the good times as well. He quietly hoped for good this time around.

"Any change?" A voice asked from the room entrance.

"No. I suppose in her case that is a good thing." Chase answered. "Any particular reason you are taking interest in my patient Dr. Wilson?"

"Oh, I think you know the reason. We are both smart enough to know what that is. You are only setting yourself up for complete punishment when he gets out."

"I know that. I'm willing to accept the consequences of my actions at that time. I don't have to now though, so I've decided to put it off."

Wilson smiled. "Not a very wise strategy, but you are a big boy. You should know how to pick your fights by now. Anyway, it's been a while. Care for a beer?"

Chase welcomed that suggestion with open arms, figuratively. "Mind if Foreman comes along? We were considering getting together later."

"Sure, it will seem like old times."

"How's that? You, Foreman and I have never gone out for anything, especially a beer."

"Okay, new times then. A beer is a beer, right?"

Chase laughed. "Yes, that's right. Okay, let's go find Foreman."

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"Wilson is here to convince me to go visit House supposedly for my own good. I'm thinking it is for his own good so he doesn't have to listen to House gripe." Chase said and he, Foreman and Wilson had their beers in their hands.

"He's right man, House will hold a grudge. I know you've put up with his misery before, but this it could get really ugly this time." Foreman wasn't sure why he was giving warning because he knew it would be ignored.

"I'll adjust." Chase replied, quickly willing to brush off any suggestions.

Wilson wasn't paying attention as he was noticing the three beautiful blond women that walked in the bar. He was rendered a bit speechless. Foreman and Chase looked over to the objects of his gaze and laughed. "Three of them, three of us," Foreman observed. "It works out perfect."

"Sorry, but I'm spoken for," Chase said, "which is too bad, because they are gorgeous."

Wilson and Foreman expressed disturbing alarm on their faces over that statement. "What?" Chase asked, not sure what prompted such a harsh reaction.

"You mean you and Natalie are that serious?"

Chase was completely confused by their reactions. "Uh, I'm not allowed to be?"

"It's not that," Foreman said backpedaling a little. "We just never pegged you to be the one woman type. Even House has gone on record a few times that you were never capable of that."

"Yeah, well people can change."

Foreman and Wilson looked at him skeptically, not buying one word of his act.

Wilson decided to break the mood. "Well I'm certainly available, so if you'll excuse me." He walked over to the blondes and started pouring on the charm. Each of the women were instantly enamored and returned the interest by throwing themselves all over him. Wilson looked like he had struck gold.

Foreman got up. "There's no way he's having all the fun." He joined Wilson and was instantly welcomed into their little social grouping.

Chase smiled at how much fun his friends were having. He had a fleeting thought to join them then quickly nixed it. Yes, he was surprising himself these days.