Fairy God Doctor

Part IX

By GeeLady

Summary: Wilson and House attend a medical conference. One of them gets into some unexpected and serious trouble and the other must come to the rescue in an unexpected way.

Rating: ADULT. SLASH. NC-17, M. Mature.

Pairing: House/Wilson

Disclaimer: I don't own Gregory House, dang-nabit!

I have done some reading with Hearing and Court proceedings, but have taken some liberties with the way things might be done. Judge for yourselves. Any oddities are mine.

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"My name is Allison Cameron. I'm head of the Emergency Department at Princeton Plainsboro Hospital. I hold a specialty in Immunology."

Harcourt left the particulars about Doctor Cameron to focus on other things. "You worked with Doctor House for three years?"

"For almost four years. I did an internship under Doctor House to learn from him."

"So not only are you an Immunologist, you trained in Diagnostics with Doctor House for those four years?"

"That's correct."

Harcourt nodded, satisfied that he'd made his point to the judge. His witness was expert enough for it to lend weight to her statements. "You are aware of the unfounded insinuations against my client?"

DeLouise quickly stood. "Your Honor, I object to the term "unfounded". Whether or not the accusations against Doctor House are unfounded has not yet been determined by Your Honor; which is why we are here in your court of law."

Judge McKenzie nodded his agreement. "Sustained. Keep your own opinions to yourself, Mister Harcourt." But the judge addressed DeLouise as well. "This court belongs to the county, Mister DeLouise. Brown-nosing will get you nowhere." Nodding to the defense, "Please continue Mister Harcourt."

"Certainly." He continued, pleased with DeLouise's dressing down.

"You are aware, Doctor Cameron, of the accusations against my client?"

"Yes, and they're ridiculous."

"Why do you say so?" Harcourt liked her spunk.

"Several reasons; least of which is - Doctor House is not a violent man."

"May the court hear your other thoughts on the matter as well, after which we can go into more detail on your personal knowledge about your distinguished teacher, Doctor House."

"First of all, there are dozens of possible causes for a rash to appear on the body of a man who is not only fevered but being dosed with broad spectrum antibiotics and anticoagulants-"

"-Anti-coagulants? Blood thinners?" Harcourt asked.

"Yes. Anti-coagulants can cause petecchia, tiny hemorrhages beneath the skin which could be mistaken for a rash. As for the diagnosis behind the rash, Red Person Syndrome is the first and most likely that comes to my mind."

"Can you enlighten the court in more detail please, about this Red Person Syndrome?"

"It is an infusion-related immunological hypersensitivity that occurs in a patient not previously known as allergic. It is most often associated with vancomycin, a strong anti-biotic designed to treat infection."

"I'd like to remind the court that Doctor Morgan was on a repeating dose of vancomycin as an infection preventative. As an expert witness, you have read the autopsy report on Doctor Morgan. Was he allergic?"

"No." Cameron continued. "But that makes no difference. The rash arises due to the release of histamine in the body, that is - the bodies attempt to rid itself of what it sees as a foreign substance. Every body produces histamine as part of immunity defense against infection."

"That's why my nose gets stuffy and runs when I have a cold. Is that right?"

"A common and harmless example, but yes. Red Person Syndrome is far more serious, but it still difficult to recognize at first. It can be mistaken for other things. A fever rash for instance."

"And Morgan had a fever, yes?"

"Yes."

"Would you say that the report of the appearance of Doctor Morgan's rash just prior to his death was abnormal? Contraindicative of a typical bout of Red Person Syndrome? In other words, would Red Person Syndrome be unlikely with such a case, even in someone with no prior allergy?"

"Absolutely not. Doctor Morgan had been on antibiotics for several days and Red Person Syndrome is peculiar to vancomycin, often arbitrarily. The syndrome can appear minutes after an infusion is started or might begin soon after its completion. There have been documented reactions occurring several days after a second infusion without any warning or prior incident."

"Can this anti-biotic cause any other adverse reactions in a patient?"

"Yes. Severe anaphylaxis."

"Excuse me, would you explain..?"

"Vasodilation, the blood vessels expand, the blood pressure drops, histamine is released is massive quantities and can lead to edema and bronchioconstriction. Again - difficulty breathing. Less frequently, angioedema can occur; that's inflammation of the heart vessels. The patient becomes dizzy and agitated, their heart rate can sky-rocket or drop dangerously low. They can develop headaches, chills, or fever."

"That's quite a list. Some of which could be mistaken for a heart attack?"

"Certainly, yes."

"What other substances injected into, say, an IV line a vein or even intramuscularly, might cause such a rash?"

"There are many. Some are cytotoxic or cytolytic; they kill or break down red blood cells-"

"-Which could mimic a rash."

"Yes. Some are cell mediated. In other words, contact reactions, causing skin irritation."

"The prosecutions contention, Doctor Cameron, is to prove by imaginative mechanisms unknown to me, that Doctor House, somehow, induced the death of Doctor Morgan by administering, by some unknown route, an unknown, and as yet un-named," Harcourt looked pointedly at DeLouise, "drug that caused Doctor Morgan's heart to stop."

"I find that unlikely in the extreme. Doctor House is not a violent man. I've never seen him hurt anything. He kept a rat as a pet instead of having it exterminated."

"Doctor Cameron, . ."

Harcourt addressed the more sympathetic faces in the room, the inflection in his voice a perfect mix of outrage and scandalous incredulity. It said that DeLouise and the money hungry family paying his salary were out for revenge or money or both, and that they had chosen Doctor House as the easiest target to get what they wanted. That they were, in fact, out for blood.

" . . .in your professional opinion, as a trained Diagnostician and Immunologist, is it more likely that this rash was a simple reaction to drugs already being administered by his attendings to Doctor Morgan, and not some mysterious substance rendered to him by Doctor House, who was only there to check on the progress of his colleague - admittedly not a visit perhaps performed as wisely as he might have done - and was simply a man unfortunate enough to be in the wrong place at the wrong time?"

Harcourt finished his detailed, elaborately phrased question and waited for Doctor Cameron's practiced response.

"I think the notion is absurd." For the first time since her questioning began, Cameron looked over at House. He looked older. He looked tired. But everything else about him was exactly as she remembered as though it were her very first day in his employ. He had the same shockingly blue eyes. He was still intense and brilliant, aloof and humorous, sarcastic and - hardly ever but just sometimes - even sweet. She was glad he was still the man she had grown to respect and eventually love.

She was also glad that he was partnered with Wilson. For years they had fought like a couple, it only made sense they'd end up being one.

Add to that - she still loved House. Just in a better way. "Doctor House is a gentle man. He may not often take to people, but I consider him a close friend."

Harcourt nodded, smiled kindly and thanked her.

"Your witness." McKenzie said to DeLouise.

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The lawyer DeLouise smiled his most pleasant smile and addressed Cameron while, using one elbow, leaning comfortably on the witness stand. "Doctor House is non-violent? That was your testimony. Doctor House is a gentle, kind man who would not hurt a fly. He was, in fact, a good boss, great doctor and all around congenial, fun-loving, good-to-his-mother guy?"

"I did not say-"

"-Gentle." DeLouise repeated, more loudly, looking around at the court as though he knew no one else believed it either. "A man given to fits of rage. A man who is a documented drug user and abuser; an alcoholic; a man who assaulted a police officer," DeLouise rubbed his forehead as though the vision of it was difficult to comprehend, "with a thermometer.

"A physician, sworn to do no harm, who, on two different occasions, assaulted a patient or family member of that patient. A man who's judgment of medically acceptable treatment is so skewed, he approved, and," DeLouise looked at the judge, "I have the legally documented records right here Your Honor." DeLouise said.

"A physician so skewed in his medical judgment that he ordered the following tests, and it's quite a list too, at one time or another to be conducted: an ECG performed on a boy with ninety percent second and third degree burns to his body, using a Wenckebach device - that's a turn of the century machine that records heart-rate and rhythm by the use of copper electrodes and buckets of water into which the patients hand and feet are placed."

DeLouise spun on Cameron. "You don't think using electricity on a burn victim is a trifle reckless, considering the risk of further infection or - let me just put this out there - possible electrocution!?"

DeLouise did not wait for her answer but again read from the document in question. "Doctor House deemed it necessary to wake this boy up from his morphine induced sleep, subjecting him to several minutes of extreme agony whereby he screamed, in order to ask him one question." DeLouise turned to the audience. "That was in the disciplinary notes of the boy's Clean Room attendant."

Cameron knew it would be too difficult to explain to a room full of laymen that it had been one of few last options, apart from the other risky things House had done that day to try and diagnose his patient. She also decided not to mention that House had injected himself with nitroglycerin to bring on a massive migraine, followed by an illegal migraine counter-active followed by dropping acid in the shower while their patient got worse, all to prove a point to another physician who had absolutely nothing to do with the case, and with whom House held a very old and bitter dispute, in order to ruin him.

Sometimes House was a little crazy. But he was also so often right, too. House had prooved the migraine counter-agent was useless.

"Does it also mention there that Doctor House diagnosed the patient, rendered treatment and saved his life?"

DeLouise ignored her comment and plunged ahead. "Doctor House once transfused himself with possibly tainted and lethal blood to test a theory. Is that correct?"

Cameron knew where this was obviously going. Make House look like a raving lunatic with a medical license let loose on society's unsuspecting public. Much of that was, unfortunately, true. Cuddy protected House from the repercussions of his own medically and behaviorally questionable actions like a parent would protect a wayward teenager. It was bizarre. It was impossible to explain to DeLouise or any of them that House, despite all his insanity, was the finest physician she had ever known who saved almost everyone ever sent to him.

"Doctor House has a fail rate near zero." Cameron insisted. "His cases are almost always unusual - medical mysteries - sent to him because no one else was able to help. I admit that his methods are somewhat...unorthodox, but you can't argue with the results."

"The ends justifies the means, in other words?"

"Stop putting words in my mou-"

"Unorthodox?" DeLouise continued reading from his wad of documents. "And as for being a last chance hero," DeLouise read again. "An AIDS victim's father was assaulted by Doctor House-"

"The father hit him first!"

"Tit for tat, eh?"

DeLouise was quick to dismiss anything with a plausible explanation, allowing Cameron no chance to interject and explain the extenuating circumstances. DeLouise completely ignored the part where the father did not press charges because not only had he admitted to hitting Doctor House first, House had saved his son's life and his own.

It was too much to explain. There were too many things that, on the surface, appeared crazy, but underneath showed reasonable cause. "That kid wanted to die. Doctor House saved his life - and the father's!"

Cameron wondered why Harcourt sat there, silently letting DeLouise publically tear his client apart. Why the hell doesn't that lawyer do something??

DeLouise ignored her, waving the papers around like a flag. "House has stolen prescription narcotics for his own indulgence from another doctor's dead patient. He has repeatedly refused to enter Rehab programs to deal with his addictions. He has ignored hospital safety protocols and medical common sense to "save a life", which I think is a laughable translation of: "play his pet diagnostic games". House has even, and I quote from Plainsboro's Dean of Medicine's notes: "during a bout of severe depression, stuck a knife in a wall socket."

DeLouise looked around the court room with his face a mask of utter disbelief. "Does any of this sound to you like the reasonable actions of a level-headed doctor with no intent to harm anyone or himself?" He turned to Cameron. "Well, forgive me for being doubtful of the motives underlying the behavior of the great Gregory House, but it sounds to me like the actions of a lunatic with absolutely no regard for anyone - not even himself."

DeLouise dropped the papers on his prosecutor's desk with a dramatic bang. "I could go on, Your Honor, there is lots more, but I think I've made my point."

McKenzie was careful not to personally comment on the drama they had all just witnessed, but only said "Indeed you have."

Cameron looked over at Harcourt. He seemed like a man drowning. Beside him House sat, his hands resting on the curve of his cane, his eyes on the table in front of him. It was impossible to read his expression.

DeLouise took a deep breath as though the pursual of House's practice history had exhausted him. "Your Honor. The family of Doctor Terrance Morgan want justice. They want to know why their father - Missus Morgan wants to know why her husband of twenty-three years is dead. Doctor House, according to sworn testimony, was the last person in the room with him; the last person to see Morgan alive and the only person with an invested interest - a personal invested interest - in seeing Morgan dead.

Cameron's eyes switched to Wilson, pale and sickly. He clearly believed House was going to go down, somehow.

"I believe it is vital to examine the behavior and therefor the motives behind Doctor House's visit to Morgan that day - according to testimony, a man he hardly knew - that is: was his visit for an innocent reason or not? And, moreover, what possible reason would Doctor House have had in visiting this patient - and not his patient as has been made clear? Certainly not treatment. Not diagnosis; Morgan's diagnosis was still under investigation by the attending staff..."

Cameron knew that was a twisting of the truth. The attendings had accepted House's contention of possibly necrotic duodenal scar tissue causing dyspnea and other confusing and dangerous symptoms, at least having accepted it to the point where they were considering an exploratory.

Only Morgan had died before they got the chance. And so the autopsy; a much delayed autopsy had confirmed the scar tissue. Though it didn't explain why Morgan had succumbed. Cameron found herself suddenly in possession of a terrible headache.

DeLouise was talking. "Your Honor. I question Doctor House's medical judgment. I question his dedication to human life. I question his very oath as a physician to do no harm. I question his very mind, Your Honor. Even a cursory examination of this man's medical practices, his own medical history containing documented histrionic behavior, narcissism, disregard for social norms, his regular disdain and disrespect toward his colleagues, should make it clear: whatever reason he might argue as a valid for his visit to Doctor Morgan that day would be, really, laughable. I think none of us believe, having learned what we have learned today regarding Doctor House's unjustifiably ill-conceived medical practices, that it was out of concern for a colleague. Certainly not human empathy. Perhaps not even curiosity about the case.

"So the question for the good citizen's of this Hearing is: Why? Why go there at all? Why visit this dying man - a fellow physician, true - but otherwise a stranger?" DeLouise turned and looked directly at House -

"Why, Doctor House?"

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Part X asap