Chapter 9
A while later the test result came back that House was right. Foreman and Thirteen came back to the conference room with the test result.
"You were right, House." House rolled his eyes at Foreman.
"After all the years you've worked for me, I thought that would be pretty obvious by now." Everyone rolled their eyes. "Still it's nice to hear. You might just make it back on my Valentine's Day card list after all." Foreman replied him sarcastically.
"I'm so touched." House smirked at him.
"Go shove the test result in Cameron's face and prepare the patient for the procedure." Everyone left the conference room and got started on their different tasks.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
When Foreman got back from showing Cameron the result of the test, Kutner and Thirteen got the patient ready and then started to conduct the test while House and Taub observed from the control room.
Kutner started talking to the patient while she was in the ice bath, and it annoyed House at first. But when the patient didn't have a heart attack after three minutes, House realized from what the patient said about mixing up room numbers that she must have brain damage.
After getting the patient back into her room House and all members of the team gathered in the conference room and talked about House's theory.
After debating for a while Kutner shook his head.
"So just because she screwed up room numbers six years ago, doesn't mean we need to do a brain biopsy. Transposed digits might be a classic marker for number confusion, but that doesn't prove she has a lesion in the left parahippocampal region of her brain. I've mis-dialed a phone number occasionally, so it could be that she just got the numbers wrong."
"She also forgot to use the bathroom this morning when she'd been informed about the test fifteens minutes before you came to get her for it. That shows an inability to predict the future." Kutner shook his head at House.
"That could just mean that she has a small bladder." Thirteen nodded.
"It could, but an inability to predict the future is also located in the left hemisphere of the brain close to the parahippocampal region." House nodded.
"And that means the damage is ongoing." Kutner shook his head.
"These two incidences were six years apart. That's nowhere near compelling evidence. It's human to forget things, which the mixed up numbers and forgetting to go to the bathroom are signs of. The cardiac arrest and platelet dysfunction point in the direction of a pancreatic tumor."
"It's more likely that it's MS. Dozens of information flow through one area to another in the brain just like the internet. When there's a lack it acts as a bad server, and it slows down the flow. If it's in the parahippocampal region it'll spread to the brainstem, which means the lungs will be next. A brain biopsy will reveal the plaques." House was about to walk into his office, and then was set to head to Cameron to get approval, but Kutner stood up trying to make his case.
"A brain biopsy is dangerous and too premature. It's more likely just a pancreatic tumor." House eyed him.
"You're not backing down, are you?" Kutner shook his head.
"No, and if you're going to Cameron to talk her into letting you do a brain biopsy, then I'm going with you to convince her to let us to do an ERCP."
Foreman, Thirteen, and Taub looked at each other and then back at House to see what he'd say.
House eyed Kutner again and when he realized Kutner would follow him to Cameron no matter what he said, he decided he might as well agree to let him come. House nodded once.
"Fine." Kutner nodded once in return and they left for Cuddy's office.
Foreman, Thirteen, and Taub looked at each other again.
"Wow. Rather amazing that House allowed Kutner to follow him." Foreman and Thirteen nodded agreeing with Taub.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Minutes later House barged into Cuddy's office. Cameron rolled her eyes when the door slammed against the wall knowing that it was House. But instead of getting annoyed with him like she'd planned, she changed her mood to curiosity when she saw that Kutner was with him. She put down the file she was reading.
"Dr. House, Dr. Kutner what can I do for you?"
"The patient needs a brain biopsy. She screwed up room numbers which is a sign of transposed digits and a classic marker for number confusion. That proves she has a lesion in the left parahippocampal region of her brain. She also forgot to use the bathroom this morning when she'd been informed about a test fifteens minutes before we came to get her for it. That shows an inability to predict the future, which is also located in the left hemisphere of the brain close to the parahippocampal region. Therefore she needs a brain biopsy." Cameron looked at Kutner.
"I'm assuming that you don't agree."
"No, I don't. She screwed up the room numbers six years ago, and getting numbers wrong is an honest mistake. And forgetting to go to the bathroom could just mean that she has a small bladder. Two incidences six years apart are not compelling evidence. The cardiac arrest and platelet dysfunction point in the direction of a pancreatic tumor, which is more likely to kill her. We need to do an ERCP." House shook his head.
"She had a heart attack. We can't wait around for her to have another. We don't have time to discuss this, because it'll hit her lungs soon. She needs the biopsy." Both House and Kutner looked at Cameron waiting for an answer. Cameron looked at them calmly and replied the same way.
"Do an MRI." House stared at her in disbelief.
"Did I just hear you right? You actually want me to do another test?" Cameron nodded.
"Yes. From that you should be able to see the MS plaques, and if they exist you can do the biopsy." He narrowed her eyes at her.
"No. I'm not going to wait around to do the biopsy when it's what the patient needs. I know you want to say yes deep down inside because you can't really tell me no despite your best efforts, and you really should say yes, but you're holding back for selfish reasons. You want to impress Cuddy and prove to everybody that you can control me and prove that you can stand up to me. But this isn't about you, it's about the patient. And the patient will die before you get your act together and make a decision. So make a decision. Him or me?" Cameron narrowed her eyes at him and remained calm.
"I stand by my decision. Do the MRI." House shook his head.
"Just another proof that Cuddy made the wrong choice, when she chose you to fill in for her." House limped out of the office without saying another word, and Cameron looked at Kutner.
"Will there be anything else, Dr. Kutner." Kutner shook his head.
"No."
"Good then do the MRI." Kutner nodded and left the office.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
After doing the MRI they all gathered in House's office to go over the results. They showed no plaques on either the right nor the left hemisphere, and there was nothing to see in the magnified parahippocampal region. House agreed that they should cancel the brain biopsy, and he let Kutner do the ERCP.
During the ERCP as Kutner was working the endoscope down the patient's throat, she started to have trouble breathing, and they found out that House was right about the lungs. Kutner wasn't all too thrilled about telling House that, and when he, Foreman, Thirteen, and Taub all returned to the conference room to talk to House, he noticed the slight smirk on House's face.
Foreman looked at House when they'd all taken a seat.
"The patient is still very weak, but she's breathing on her own." House gave a single nod.
"Lung failure. Now that proves that one of us was right." He turned to Kutner and smirked. "Can you remember, who said that?" Kutner just nodded.
"Even though it proves that you were right in that her lungs would fail, you were still wrong because it wasn't MS." House nodded.
"Yeah, I was right about the where, but apparently not about the what." He thought for a second and then leaned forward in his chair resting his elbows on the table. "A picorna virus could cause localized demylination that the MRI wouldn't show. We need to run a nerve conduction study on the surface of her brain and that will tell us where the dead spots are." They all looked at each other, but Taub was the one to speak up.
"Wauw, wauw. You actually want us to cut into her skull?"
"Not quite. I'm more talking about cutting off her skull. We need to expose her brain." Kutner shook his head.
"That's too risky. It could still be a pancreatic tumor. That explains the heart, the blood, and her lungs."
"But the ERCP was negative." Kutner looked at Foreman.
"We just need a more sensitive test. We need an endoscopic ultrasound." House shook his head.
"Oh for god's sake, would you just admit that you're wrong."
"You were proven wrong too, but yet you get to do a second test?"
"I was right about the brain in the first place, which probably means I'm right again, so we don't have time to run your test just to see that you're wrong." Kutner smirked a little.
"And I'm just sure that Cameron is willingly going to agree to let you cut off our patient's skull." He got up and headed for the door. "I'm going to do the endoscopic ultrasound." When he was out the door Taub stood too.
"I'm going with him." House nodded and when Taub had left, Foreman looked at House.
"I guess you'll be going to Cameron to ask for approval." House nodded and got up to leave.
"Of course." When he had left Foreman and Thirteen looked at each other and just shook their heads.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Minutes later House barged into Cuddy's office, but having gotten off the phone with Kutner a minute ago, she wasn't surprised to see House.
"Hello, Dr. House. Come to ask me for my approval to cut off your patient's skull?" He narrowed his eyes at her as he approached the desk.
"So, Kutner called you."
"Yes." She shook her head. "That kind of treatment is not AMA approved for MS."
"I can see Kutner didn't fill you in on everything. I'm searching for what set off the MS. Equine encephalitis."
"The way to get that is by a mosquito, which is unlikely due to the cold weather we're having, or have you not looked outside?" House started to get slightly annoyed.
"Then she either got bitten six months ago or it's from some other infection. Whatever caused it is running wild in the left side of her brain. Once I've cut off her skull, I'll get you the details." She shook her head.
"That answer is not good enough. Not for the kind of procedure you're asking approval for." He shook his head getting more annoyed.
"The test is the proof. I can't give you anything else."
"Well, you're going to have to try, because I'm not giving you my approval with the current information."
"You're risking the patient's life."
"If you don't have any more proof at the moment, Dr. House, then we're done." Without another word House limped out of the office quickly.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
When House came back to the conference room Foreman and Thirteen were still there. They both looked at him.
"What did Cameron say?"
"That there wasn't proof enough to do the test."
"You can't honestly be surprised she said no." House ignored Thirteen's remark.
"I need you to go to the patient's work place and look for mosquitoes or anything that might've caused equine encephalitis. Check every room she's been in." They both nodded, got up, and gathered their things without another word.
When they were gone House limped into his office and sat down in his armchair. He put his right leg up and then got out his Vicodin. After dry swallowing two pills he started to massage his leg.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
A while later Foreman and Thirteen returned with their findings and gave them to House, who were then off to see Cameron once again.
When House barged into Cuddy's office, Cameron was sitting on the couch with her head over the table and about to take a sip of coffee. But because she got startled, she ended up spilling coffee on her shirt and a little on the table. She looked up at him and glared at him and spoke to him sarcastically.
"Thank you very much for that." House just shrugged as she wiped the coffee off of herself and the table.
"Good thing you weren't sitting at the desk. Cuddy would've been pissed at you if you'd gotten coffee on her desk." Cameron just narrowed her eyes at him when she was done wiping off the coffee.
"I assume you have something for me?" He nodded holding up the clipboard and a small vial.
"Yes, I've got a lab test and three dead mosquitoes." He handed them to Cameron. "Well, I'm off to cut my patient's skull off."
"You're not going anywhere until I read this through carefully." She looked at both items and then gave him a glare. "The student you took the sample from has the common cold, and these aren't mosquitoes, they're just banana flies." House shrugged.
"Same thing."
"No, they're not the same thing. This is not sufficient proof of what I asked for." He started to get angry.
"Kutner didn't find anything when he did the endoscopic ultrasound, which just proves that since it's not her pancreas, it's her brain."
"It doesn't prove that."
"Oh come on, Cameron. You were on my side once. Remember? What I just gave you used to be sufficient evidence. The only test left for me to do is the one test you won't let me do. So if I can't do it, I can't do anything else for the patient." She gave him a glare.
"I'm sorry, Dr. House, but you're just going to have to keep doing more tests that are less harmful, because I'm not letting you cut your patient's skull open with what you've found so far. Bring me sufficient evidence and you can do the procedure." House looked at her in disbelief. But that only lasted two seconds. He snapped the clipboard and vial out of her hand angrily and got out of the office quickly.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
When House got back to the conference room Thirteen was the only one there.
"So what did Cameron say?"
"What do you think she said?"
"I guess it was a no." He replied her sarcastically.
"Oh really? Well enlighten me on how you reached that conclusion. What gave it away? The fact that you didn't get a page telling you to get your ass to the OR?"
"So what are we going to do now that we can't cut her skull open?" He stood staring out into space for a moment and then got an idea. He started to limp towards his office.
"Grab your coat, the patient's file, and the different test results." She looked in his direction a bit oddly, but figured it was best to do as he said.
When she noticed him getting out of the door in his office with his coat on, she got out of the door in the conference room and met up with him in the hall.
"Where are we going? Are we going to look for more sufficient proof?" He nodded as they waited for the elevator.
"Yeah, something like that."
"Are we going to tell the others?"
"Nope." She rolled her eyes when they stepped inside of the elevator.
When they reached the lobby House limped quickly towards the entrance and Thirteen was a little impressed by his speed, but said nothing.
When they got to the parking lot the silence finally got to her.
"Where are we going?" He ignored her question.
"Where's your car, or did you get a ride with lover boy?" She rolled her eyes.
"It's the first one on the left after the handicapped spaces." House was glad she'd gotten a space close by, so that he didn't have to walk that far.
"Great." He walked towards it. She rolled her eyes but followed him. When they reached the car, he looked at her. "Open it so we can get moving."
"Could you at least tell me where we're going? If we're going somewhere to look for sufficient proof, why are we bringing all the test results and the patient's file?"
"We're not going to look for sufficient evidence." She looked at him confused.
"If we're not doing that, where are we going?"
"We're going to Cuddy's to get approval to cut off the patient's skull." She gaped at him for a few seconds but then shook her head.
"We can't do that. Cuddy's on leave and she put Cameron in charge." House snapped.
"And she was wrong in doing both." Thirteen gaped at him again. "The only thing left to do is to cut the patient's skull off. But little Miss I-need-to-prove-myself, is standing in our way, and by doing that she's killing the patient. Cameron might be in charge, but Cuddy's still the Dean." Thirteen shook her head.
"I'm not going. If you want to go, you can go on your own." She was about to turn around to leave, but didn't get the chance as House spoke to her harshly.
"I fired you once, so don't think I won't do it again." She gaped at him for a few seconds but then sighed knowing there was really no point in arguing with House. She nodded.
"Fine. But I'm calling Cuddy to let her know we're coming."
She got out her cell phone, but when she brought it up higher to her face and was getting ready to dial, House swung his cane up from its position on the ground and hit her on the back of her hand, causing the cell phone to fly out of her hand and in his direction. He caught it with ease. She gave him an angry glare, but he just glared back.
"No calling Cuddy."
"We can't just show up at her door without letting her know we're coming. Especially not since she's on leave."
"We can and we will. Now get in the car. We don't have time to make meaningless conversation." She rolled her eyes but did as she was told and soon they were off to see Cuddy.
TBC
