NOTES: See, look—a nice normal update interval. Commentary is linked from my profile. (And if anyone's interested, I also linked the pictures from my trip to see JS/Band from TV in Miami in May.) If you're still reading this, please let me know. I know it's been a while.
Chapter Nine: Compliance
The elevator seems suddenly too tight, the atrium too quiet and the air too still as Chase makes his way to Cuddy's office. She's on the phone, he can see through the partially open drapes, and he stands outside the door for a long moment, trying to swallow down the overwhelming sense of trepidation that seems to root his feet to the tile floor. He can see his reflection in the glass of Cuddy's window, still gaunt almost to the point of frailty, the darkness under his eyes now the product of exhaustion rather than sickness. But illness is all that anyone will see when they look at him, he thinks. Despite all his attempts at normalcy, at regaining some semblance of a routine, everyone who knows will only see the potential for disaster in his every action, like Cameron's concern over the coffee.
House's words echo in his mind, tightening the knot of anxiety that's been a constant resident in the pit of his stomach since his diagnosis. He wants to believe that it isn't wrong to try to get back to his life, to minimize this so that it doesn't become all-consuming. Cameron is just trying to help, he knows, but the last thing he wants is for this to impact anyone else. House is using this to manipulate and study him, Chase tells himself. He's done this a thousand times before. House knows exactly where to poke and prod to expose people's insecurities. What he's said ought to be meaningless.
And yet—House is always right.
It's the last thought in his mind when Cuddy suddenly puts down the phone and comes to open the door of her office, and it lingers like a bitter aftertaste, turning his stomach.
"Dr. Chase. Come in." Cuddy is wearing the sympathetic smile Chase is accustomed to seeing directed at the families of patients House has upset, and he keeps his eyes downcast as he steps inside. He can feel her gaze on his back as he makes his way to the chair in front of her desk, knows that she is comparing the things she's read in his chart to any physical signs of illness. It's exactly how he would approach a patient, but sensing it from a colleague is deeply unsettling.
"Dr. Cuddy." Chase nods, folding his hands in his lap and wishing for the umpteenth time that he'd thought to at least wear his lab coat, so it wouldn't be so glaringly obvious how much weight he's lost. "You wanted to see me?"
Cuddy walks around the other side of her desk, straightening up the piles of papers on the surface before addressing him again. The air seems too thick again, every muscle in Chase's body tense almost to the point of soreness. He realizes suddenly that he can't remember the last time he felt truly relaxed.
"Yes." Cuddy glances up, finally. "Can I get you anything? Coffee? Tea? Water?"
It's unlike her, and Chase shakes off lingering defensiveness from the morning, telling himself that she's just trying to be considerate. If there's anyone he needs to prove his competence to now, it's Cuddy. "I'm fine," he answers tightly.
"Okay." Pulling out her chair, Cuddy sits as well, folding her hands on the surface of the desk in a perfect mirror image of discomfort. Chase has suspected from the moment House notified him of the meeting, but suddenly he's absolutely certain what this conversation is going to be about. "It's good to have you back at work. I just thought we ought to discuss--"
"You want to know how I'm doing," Chase cuts in, surprising himself. He's never been particularly given to aggressiveness, or even assertiveness, really. But now, in the midst of losing every confidence in himself and his ability to do his job, he can't seem to stop these outbursts, stop defending himself and pushing people away. It's like there's a monster inside of him along with the disease, poking and prodding until Chase is in control of nothing—not work, not his relationships, and certainly not his health.
"Yes," Cuddy answers. "It's my job to ask. And I'm—concerned. You've had some hard news in the past few weeks."
"Are you concerned for my well-being, or that I'll be a liability for you now?" It's like listening to himself from very far away, all the thoughts which once remained silently in his mind now given voice, whether he likes it or not. "It's your job to worry about that too, isn't it?"
Cuddy sighs, and Chase can see that she's making an effort to remain calm and patient. "Dr. Chase, I have every confidence that you are an excellent doctor. Therefore, I trust that you can not only take care of yourself, but continue to care for your patients as well. That's not why I asked you to come here this morning."
"Then what did you want?" Chase looks down at his hands, digging fingernails into the underside of his palm where she won't be able to see. He can already make out the beginnings of scars on his fingertips from all the needles, and wonders absently what they will look like years from now. Yet another reality of disease for which medical training has not prepared him.
"You only took a few weeks of leave. You came back full-time as soon as you got clearance. You can have more time if you need it," Cuddy offers.
"I don't," Chase answers, too quickly and probably more firmly than necessary. "I told you, I'm fine."
"Okay. Well, as you know, your health insurance will continue to be covered through the hospital, so you won't need to worry about that. We do have the occasional clinical trial here for new diabetes management techniques, if you want I can look into getting you information about that." Cuddy is already searching through yet another stack of papers, pulling something up on her computer without waiting for a response.
"No," says Chase, the thought of being someone else's lab rat suddenly unacceptable. He's never looked at it this way before, never had a problem helping House do whatever was necessary for the supposed good of the patient.
Cuddy looks taken aback, and Chase is sure she's expected gratitude in return for her offer of support. And yet, he can't bring himself to feel guilty. "Well, we can talk about other accommodations, if you'd like. We can reduce your hours, if that would help. Eliminate your obligation to the clinic. Just let me know what you need, and we can work out--"
"Nothing!" Chase snaps, on his feet before he realizes what he's doing. Cuddy is still seated, now gaping at him in shock, and he knows he ought to apologize. But at the moment it's all he can do to stay within the bounds of civility. "I just—need everyone to leave me alone. Let me do my job. Stop acting like this affects you, because it doesn't. As far as you're concerned, nothing's changed."
From Cuddy's office, Chase finds his way to the clinic, still in a haze of confused emotions, and suddenly desperate for anything else to focus on. He hasn't done any real work so far in the few days that he's been back, and he finds himself strangely disappointed that the previous day's case was resolved so quickly, before he'd had a chance to play a part at all. The clinic seems at once like a refuge, engaging enough to keep unwanted thoughts at bay, yet so routine that he has no doubts in his abilities.
"Dr. Chase." Nurse Previn gives him an appraising look by way of greeting, and he swallows down the thought that she must have heard the gossip about him as well. She is irrelevant to his ability to work here today, and she always treats everyone as though they might be plotting a coup besides.
"Looks busy today," Chase answers, determined to act as though everything is normal. "Got a file for me?"
He barely glances at the chart before going into the exam room, expecting a routine cold or injury too minor for the ER to treat. But the man he's confronted with is anything but typical. The patient is seated in a chair next to the examining table, and Chase realizes immediately that this is because his weight is too great for the metal surface to support. A glance at the chart tells him the man's current weight is 432 pounds.
Chase clears his throat. "Mr. Emmerson?"
The man nods sourly, like the greeting is an offense. "That's me."
Examining the chart more closely, Chase tries to gather up the pieces of his training and get his brain back on track to treat this man. He feels as though it's been years since he's seen a patient, rather than the actual few weeks. "Says here that you had gastric bypass surgery two months ago, and have lost forty pounds so far since then." Glancing back up, Chase notices that the man's skin is starting to look the slightest bit sallow, indicative of extremely rapid weight loss.
"That's right." Flat, abrupt, and edged with the slightest hint of defensiveness, like a warning against saying the wrong thing.
"And...you're here now with a complaint of unremitting diarrhea and constant nausea," Chase finishes, getting to the end of the chart. "How long has this been going on?"
Mr. Emmerson shrugs. "Pretty much since I had the surgery. They said it would get better, but...If I'd known I was going to feel like this for the rest of my life, I never would have had the operation! My doctor said I'd die if I didn't lose weight. Well, I'd like him to know that I'd rather die fat than be miserable!"
"Okay, okay." Chase holds up a hand to try and calm the other man. "May I ask why you're here, and not at your surgeon's office? This is really a concern that should be discussed with him. I can give you a mild anti-emetic, but with the risk of post-surgical infection, you should really get checked--"
"He doesn't listen to me!" Emmerson explodes, turning red in the face. Chase jumps reflexively, the excess of adrenaline he's built up from the morning betraying his attempts at calm.
"Have you told him how severe your problems are?" Chase tries again. "The point of the operation is to improve general health and quality of life. If either of those is compromised after the fact, I'd certainly think he'd want to know--"
"He doesn't care!" Emmerson interrupts again, hauling himself to his feet with effort, and the exam room suddenly feels uncomfortably small to Chase.
"All right." Chase takes a step backward, trying to be inconspicuous about the motion. "Well, the best I can do for you today is to give you an anti-emetic. And I can refer you to a different bariatric specialist, if you'd like."
"No!" Emmerson insists, breathing harder. His breath has a foul smell, Chase realizes, and wonders absently if it's a result of tooth decay caused by the constant nausea. "I don't want another bariatric doctor. All they do is tell me to change the way I eat! The whole point of getting the damn surgery was so that I didn't have to do that! If I wanted someone to tell me to change my eating, I would have gone on a god damn diet instead of having someone cut me open!"
"Wait." Chase pauses, glancing at the chart again, and trying to ignore the growing sense of panic that's blossoming in the pit of his stomach. "You're telling me you haven't been following the dietary instructions your doctor gave you? I know they can be difficult, but that's probably why you've been feeling sick. It's very important for you to follow that regimen, or you won't get the nutrients you need."
"Damn it!" Emmerson roars, and Chase is certain the rest of the clinic can hear him through the thin walls. "You're just like the rest of them!"
"I'm going to order some bloodwork," Chase continues, glad for the excuse to look at the chart instead of the patient. It's hard not to see himself in the man's eyes, filled with frustration and hopelessness and grief. "Between the surgery, the nausea, and the diarrhea, you're probably malnourished. We can get you on some vitamin supplements, and that should help you get some of your energy back."
But Emmerson isn't finished yelling. "It's so easy for you all! Look at you! Thin, blond, attractive! You have it all! I bet they even gave you a free pass through med school just for being so damn good-looking! And here you are, preaching to me like you know what I'm going through, you arrogant son of a bitch! I bet you've never been sick in your life."
"Enough!" The sound of the file slamming against the exam table makes Chase jump, though it's his own hand that's brought the folder there. "This isn't about me! It doesn't matter what I do or don't understand, what matters is that I'm your doctor right now and you need to comply with the guidelines you've been given! Otherwise don't expect anyone to feel any sympathy for you when you get sick. You did this to yourself, and you're apparently not done making it worse."
Chase is out of breath when he runs out of words, shaking and sweating in the small room. A hush has fallen over the noisy waiting area outside, it seems, and Emmerson is looking over Chase's shoulder, not reacting. Turning slowly, Chase is horrified to see the door open and Cameron standing just inside it, a look of slack-jawed shock on her face.
"I'll—go give these orders to the nurse," Chase says weakly, clinging to the last shred of professionalism like it might somehow be able to save this disastrous appointment.
"No, you won't," Cameron says firmly, stepping forward and taking the file from his hand. "I'll take care of this. Maybe—maybe you should go home. Or see your doctor, get--"
"No!" Chase cuts her off, desperate that this man not hear the reality of his own situation. "I'm fine!"
But Cameron only shakes her head, and the sympathy in her eyes is agonizing to look at. "You are not fine."
Without another word, Chase turns and hurries out of the room, walking as quickly as his legs will carry him short of a full-fledged run. Keeping his head down, he doesn't stop until he finds himself inside the wooden doors of the chapel.
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