Disclaimer: House and all respective characters do not belong to me. I am only borrowing them for personal enjoyment.
Also I am not a doctor so I have decided to borrow cases used earlier in the show for medical accuracy. My creativity comes in with building and developing character relationships as well as introducing original characters. Criticism and reviews are most welcome. Hope you enjoy
A/N: Told you the new chapters would be coming quickly. How is everyone liking all the chaos? How is Trzaska doing with his first solo case?
Meanwhile Thirteen opens her apartment door to Chase.
"One portable ultrasound, extra pepperoni," Chase jokes.
Thirteen takes the machine. "Thank you so much. I might be late tomorrow." She starts to close the door, but Chase puts his hand out to open it again.
"Your socks are dry," Chase says. "And, unfortunately, so is your shirt, which means you either just changed to greet me, or you need this for something medical." Thirteen hesitates, and doesn't answer him.
"I am a doctor," Chase says.
Thirteen lets him in her apartment. Chase enters the living room and stops when he sees Darrien lying on the couch. A look of shock crosses Chase's face. "She's my friend," Thirteen says. "I was in prison."
A little while later House is sitting on a CT table in his underwear slapping at his arm to expose a vein. A monitor reveals that his heart rate is 110 bpm. He inserts an IV needle, lies down and pushes the button, which slides the table into the CT machine. Once inside, he pushes another button, which starts the scan. After the scan House sits slumped on the CT table as he waits for the scan to process. A short time later House begins looking at the film. There are multiple black spots seen in the scan of his leg. He slowly lowers the film and looks devastated.
Meanwhile at Thirteen's apartment, Chase is pacing as Thirteen uses the ultrasound machine on Darrien's chest.
"You killed your own brother," Chase says putting the pieces together.
"Yes, it was awful and devastating, but it wasn't murder," Thirteen defends. "He was sick and he wanted to die, and I promised I would help. Now please stop pacing and help me find this thing."
"Have you talked to anybody about it," Chase asks. "I mean, are you okay?"
"No, I may have an aortic arch aneurysm," Thirteen says. "Oh, wait, that's her. Either help me or leave."
Chase puts down the drink can he was holding and takes off his jacket.
"Having trouble getting a clear look," Thirteen says.
"Try a long axis view from the suprasternal notch," Chase suggests. He comes over beside Thirteen and prepares to examine Darrien's wound.
"Wait," Thirteen shouts stopping Chase in his movement. "Put on some gloves. She's got Hep-C."
"Wonderful," Chase says. He puts on a pair of latex gloves. "Take it you two were cell mates."
"Just friends," Darrien says.
"She saved me," Thirteen says. "There's a culture in prison. If you don't have someone to show you how to get the stuff you need and stay away from the stuff you don't, you're screwed."
"Her fingers are turning blue," Chase says. He looks at Darrien. "Can you move those?" Chase looks more closely at Darrien's left hand.
"My arm's starting to go numb," Darrien says.
"Arch of aorta's clear," Thirteen says. "This can't be an aneurysm."
"Maybe the wound threw a clot," Chase says. "Check axillary arteries." Chase raises Darrien's left arm above her head, and Thirteen moves the ultrasound wand up to Darrien's left armpit. "Stop." He points to a spot on the monitor. "Right there." Chase starts digging around in a duffle full of medical paraphernalia.
"Five centimeter gooey mass," Thirteen says. "Not a clot. Maybe a lipoma?"
"What the hell is that," Darrien asks.
"Fat-filled sack," Chase says. "Probably aggravated by the stab wound." He's still rummaging. "You got any syringes in here?"
"Give me that," Thirteen says to Chase. Chase gives the duffle bag to Thirteen, then takes hold of the ultrasound wand as Thirteen searches through the bag for a syringe.
"I was stabbed in my gut, not in my arm," Darrien says confused.
"You lost a lot of blood," Thirteen says. "Gave the lipoma room to swell. It's compressing the arteries in your arm, blocking your blood flow. Maybe we can suck some of it out. You'll be fine." Thirteen has pulled a syringe out of the bag and pulled off the paper wrapping. She now prepares to insert the syringe into Darrien's armpit. Thirteen inserts the needle. "Little pinch."
Chase watches as Thirteen slowly pulls out the plunger. "That's not a lipoma."
Meanwhile at a strip club, upbeat dance music is playing and a couple of pretty young woman are pole dancing. Taub is at the end of the stage sipping on a drink through a straw. He is not watching the dancers. "I don't know why she's even considering having my kid.," Taub says. "She barely knows me. All she knows is I'm a short, balding guy. It doesn't even make evolutionary sense."
Foreman looks over at Taub for a second and then returns his attention to the dancers on the stage. "You want her to keep it," Foreman asks.
"No," Taub says.
"'Cause you'd make a crappy dad," Foreman says.
"I said, no," Taub says.
"You're too selfish," Foreman says. "That's why you cheated on your wife, why your marriage fell apart…"
"Dude, I said…" Taub starts.
"I know you," Foreman says. "The only reason you're sitting in a strip club, ignoring the strip club, is because you actually are considering it."
Taub doesn't know what to say to that. Instead, he pulls out a folded wad of cash and holds it up for the strippers. "Although without crappy dads in the world…" Taub says. One of the strippers rubs Taub's shoulder and pulls him up off his stool. Foreman just shakes his head in disbelief.
Back at the hospital Trzaska is talking to Dr. Prather, the oncologist running the trial. "We've sequenced the DNA of the tumor cells," Trzaska says. "P53 gene mutation at codon 55. She's perfect for your trial."
"She's pretty far advanced," Prather says looking at the slide.
"Well, you want easy cases, you picked the wrong specialty," Trzaska says.
"Otherwise in good health," Prather asks.
"Excellent," Trzaska replies.
"When can she start," Prather asks.
"Middle of next week," Trzaska responds.
"Cancer's already stage three, it'd be a waste of time," Prather says.
"She can start in two days," Trzaska says smiling.
Trzaska meets up with Wilson who spoke with Prather on the phone after Trzaska left. They walk down a hallway together talking.
"She can't start in two days! She's pregnant," Wilson says.
"She won't be in two days," Trzaska says. "I've scheduled a C-section."
"She'd still have to wait a month," Wilson says. "You can't take part in a trial until 30 days after major surgery."
"Well, it's definitely surgery, but major," Trzaska asks.
"You're scamming a doctor, now," Wilson asks. "You've only been here for a few months and already you're acting like House. There's more to this job than that. There's more to life than that." Wilson's tone becomes slightly angry and scolding.
"But House gets things done doesn't he," Trzaska asks. "He saves lives. That's what I care about. Not stupid regulations."
"These regulations aren't just here to annoy you, okay," Wilson responds back, now lecturing Trzaska. "Doing this is dangerous to the patient."
"Well, I'll be sure to let her know that," Trzaska says. "Care to join me?"
Wilson stops in the hall while Trzaska continues to Riley's room.
"Angiogenesis inhibitors prevent the tumors from creating blood vessels," Trzaska starts. "Without blood, the tumor starves."
"That sounds great…" Shane says.
"What about the baby," Riley asks.
"The treatment would be fatal to the baby," Trzaska says bluntly. "I've scheduled a C-section for later this afternoon. It's in the trial phase right now, but so far complete remission in more than thirty percent of subjects."
"I told Dr. Wilson I didn't want a C-section," Riley says.
"When your chances of living were less than a third of what they are now," Trzaska says.
"Well, the baby's premature, that…" Riley starts.
"Our pediatrics department has the best neonatal ICU in the state," Trzaska interrupts.
"No, his lungs, his brain, he's not ready," Riley says.
"And he could be fine," Shane says.
"You don't know what it's like, raising a sick child," Riley yells at Shane. Trzaska looks up, interested.
"His odds are much better than yours are," Shane says. "You have to let them at least try this." He looks at Trzaska. "Talk to her."
"Okay," Trzaska says. "Leave the room." Shane does what Trzaska asks. "How long have you been taking oxybutynin?"
"Uh, since I was about twenty," Riley responds.
"Incontinence is pretty uncommon in a woman of your age," Trzaska says. "It's even more bizarre in a woman in her twenties."
"I guess I haven't had the best luck when it comes to my health," Riley says looking away from Trzaska.
"Seems that way," Trzaska says. "You said to your husband, 'You don't know what it's like, raising a sick child.' You didn't say, 'You don't know what it would be like.' This is not your first child, is it? And he doesn't know."
"I was eighteen," Riley answers. "Got pregnant, got married. I had the most beautiful little girl, Grace. She had infantile Alexander's disease."
"I'm sorry," Trzaska says.
"For two years we watched her die," Riley says, her voice shaking. "My husband was, uh, my first husband was a, a great guy, but after that I couldn't even look at him without thinking of her. I left him, I left my job, I left everything …"
"Very moving story," Trzaska says. "Explains why you're being so selfish."
"I'm willing to die to protect my husband," Riley says.
"Because it's what you want," Trzaska responds. "Your husband wants you to live."
"Well, he doesn't understand…" Riley starts.
"Oh, who the hell does," Trzaska says angrily. "Tragedies happen. You think that turning yourself into a disposable incubator for a few weeks is going to protect your baby from all the crap in this world, go ahead, die happy. I got no problems with people killing themselves, but don't think it makes you a hero."
Riley starts crying from Trzaska's rant. "Okay."
"You're scheduled for four p.m.," Trzaska says leaving.
Meanwhile, Thirteen pulls a full syringe of blood out of Darrien's armpit. "Try moving your fingers again."
Darrien wiggles the fingers of her left hand as Thirteen caps the syringe.
"Good," Thirteen says. "Means it's almost drained." Thirteen puts the full syringe down beside four other syringes full of blood.
Chase pulls on a fresh pair of latex gloves. "Not good enough. We don't know if it's gonna come back. We don't even know what it is. Drugs, viruses, toxins from that crack house and God knows where else she's been."
"If this were caused by the drugs, she'd have kidney failure, cardiac involvement," Thirteen says.
"What about her Hep-C," Chase asks. "Could have fried her liver. Loses its synthetic function." Chase comes over and sits down beside Thirteen in front of the couch where Darrien is lying.
"Then her entire body would be swelling, not just her arm," Thirteen says.
"That leaves us with toxins," Chase says. He looks over at Darrien. "Where exactly were you when you were attacked?"
"You're not doing a home search in a crack den, that's insane," Thirteen says.
"Apparently, we don't have much of a choice," Chase says.
"It's a crime scene," Thirteen says. "And it's not toxins or viruses or anything else you mentioned, because it's not a coincidence. Her symptoms have to be related to the stabbing."
Chase is on his feet again, pacing.
"What if her body used up all the clotting factors dealing with the stab wound," Thirteen suggests.
"Explains the bloody mass," Chase says. "But if you're right, she could start bleeding anywhere, like in her brain or in her heart."
"One of those things could start growing in my brain," Darrien asks.
"It's time to get you to the hospital," Chase says.
"Oh, no," Darrien says. She looks at Thirteen. "Remy, you promised."
Thirteen looks up at Chase. "All we'll do at the hospital is stick her in a patient bed and give her IV clotting factor. We can do that right here."
"We could also embalm her right here," Chase says sarcastically.
"I'll call the drugs in," Thirteen says. "You go pick them up. If I'm right, she'll be fine. Look, I know you don't know her and you don't care about her, but I do. Please."
Meanwhile at the hospital, Dr. Lim is getting ready for the surgery in the OR, but a nurse has a phone up to his ear.
"Yes, this is Dr. Lim," he says into the receiver.
The nurses are talking about various happenings, and the anesthesiologist begins to put Riley under. "Count down from ten," the anesthesiologist says.
"Okay," Riley says nodding. "Ten… nine… eight…"
"That seemed kind of fast, is she all right," Shane asks concerned.
"She's fine," the anesthesiologist says.
"Wake her up," Dr. Lim says. "That was Cuddy; surgery's off."
The anesthesiologist wakes Riley up and she is transported back to her room.
Trzaska knocks on Cuddy's door. She is packing her things after working late and answers him. "Come in."
Trzaska barges in and closes the door behind him. Turning around, his face is angry. "What's the idea pulling my patient out of surgery?"
"When I asked you to work emergency tonight I wanted you to treat everyone that came in, not pick one case and treat only her," Cuddy replies shoving a notebook into her soft briefcase.
"I have been treating multiple cases," Trzaska says. "And you haven't answered my question!"
"Because you were trying to ram her into a drug trial five minutes after surgery," Cuddy says.
"She knows the risk, she was fully informed," Trzaska shouts.
"Well the guy running the study sure wasn't," Cuddy says back.
"Not his life! Not his call," Trzaska says his voice still getting louder. People outside Cuddy's office are wondering what's going on.
"His study, his call," Cuddy says back. Her voice intensifying but still calm.
"Right so she kicks off his numbers look bad," Trzaska says annoyed.
"The numbers look bad the study looks bad," Cuddy insists.
"Which would cost you money," Trzaska says still annoyed.
"And keep a potentially life-saving protocol off the market," Cuddy says back.
"Oh to hell with that, she's being condemned to death for some stupid rule," Trzaska says.
"Listen to yourself," Cuddy finally shouts at him, stepping around her desk and in front of Trzaska. "Sit down," she says pushing his shoulders down, forcing him to sit on the couch. "Wilson's right."
"I already had one lecture today, I can't stand another," Trzaska says standing up.
"I wasn't finished," Cuddy's tone was harsh this time, her voice leaving no room for argument. "House has a lot of good qualities, and he saves a lot of lives that would otherwise be lost. But he doesn't have your compassion." She sits down and places a hand on his knee. "Never forget that. You can be as great as he is, without being the ass he is. House reminds me every day that there are stupid rules. But there are some that have a good reason. Try and remember that."
Trzaska nods and leaves Cuddy's office. His leg bothering him a little, he pops two of his tramadol. And limps up to talk to Riley and Shane.
A little later House is on his hands and knees scrubbing the floor, and the tub. After he's finished House stares at himself in the mirror, then looks down to a collection of surgical instruments laid out on a table. Next to it a line of syringes, then a bottle of Vicodin alongside a shaving brush in a glass sitting on the sink. House picks up the bottle of pills and takes four, washing it down with a handful of water, and putting the bottle back on the sink. He then proceeds to scrub his hands and forearms thoroughly. There is a small table next to the tub, covered in surgical draping. The surgical instruments are laid out neatly on the table. There are two flexible arm lamps clamped to the table, one of them is a magnifying lamp. House is wearing only a t-shirt and boxers. The scar on his right thigh clearly visible. House continues with his preparations. He tapes the CT film onto the wall tile of the bathtub. The patient information includes his name, DOB (5/15/1959), gender, and his doctor (Hourani). He places a stack of medical books on the right side at the foot of the bathtub. House now sits on the edge of the tub. He has a wooden spoon in his mouth and is preparing a tourniquet out of the tube of a bicycle tire. House wraps the tourniquet around his upper right thigh above the scar, then takes the spoon out of his mouth and twists it into the tourniquet to make it tighter. He grimaces as it tightens. Behind him, is a rolled up bath towel which he has taped to the wall beside the CT scan. House rises unsteadily, his hand on his upper thigh. He looks to a row of seven full syringes. On either side of the syringes are some gauze bandage and his cell phone. House lowers himself carefully into the tub and places his right foot against the stack of books. On the instrument table is a portable cauterizing instrument, forceps, retractors, the syringes, and House's cell phone. House looks at the CT film and pans down the scan, to reveal three tumors in House's upper thigh, each circled in red. The largest tumor is high up, and close to the scar tissue. Two smaller tumors, situated close together, look to be an inch or two below the large one. House puts on latex gloves and sterilizes his thigh. He puts the sterilization sponge into a small metal bowl, then picks up one of a series of ten syringes which are laid out on the table. He takes off the cap, tossing it onto the floor, and with another glance at the CT scan, plunges the needle into his thigh. After pushing the anesthetic into his leg, he tosses the used syringe onto the floor and repeats the procedure with another syringe. He uses up five of the syringes, pushing the anesthetic all up and down his thigh, as indicated by the CT scan. He stops and uses his thumbs to assess the numbness of his thigh. He looks up with a determined expression, as if steeling himself for what he is about to do. House picks up a scalpel from the table and removes the cover. He holds it over his thigh and pauses for a long moment, bracing himself. He then takes a deep breath and makes a long incision in his upper thigh.
Meanwhile back at Thirteen's apartment, she is getting Darrien situated on her bed. "Lie down, elevate your shoulder," Thirteen tells her. Darrien groans as Thirteen positions her on the bed, then sits on the bed beside her. "You said Andre wasn't responsible for the drugs. What is?"
"Oh, I don't know," Darrien says blowing it off.
"Yes, you do," Thirteen says really trying to help. "What happened to you? If you don't deal with the real problem…"
"I came here because you're a doctor… not a shrink," Darrien says. Darrien turns away from Thirteen who finally gets up and leaves.
Back at House's, he is in his bathtub concentrating hard and clearly in pain. He has used retractors to spread open the incision, and is using the magnifying lamp to work on his leg with a pair of forceps. His hand is shaking and he is sweating. He wipes the sweat on the rolled up towel on the wall and turns back to his leg. He has located a tumor. He grits his teeth, but is shaking with pain and cannot get ahold of it. He picks up another syringe, and glancing at the CT scan pushes the anesthetic into his leg. The wound is bleeding heavily. He uses the portable cauterizer to seal off some blood vessels. His toes flex against the stack of books. Taking up the scalpel again and grimacing in extreme pain, he cuts the tumor away from the tissue in his leg. Using the forceps, he manages to extract the tumor from his thigh. With a shaking hand, he deposits the tumor into a small metal bowl on the table. House looks at the CT scan again. He wipes his forehead on the towel and prepares to excise a second tumor. His hand is shaking so badly that he can barely see what he is doing. "Ugh!" As the scalpel touches the tissue, he screams, and throws back his head in agony. He shakes his head and groans as he tries to continue with the surgery. "Ah! Ugh! Ugh!" House grunts and yells as the pain finally gets the better of him and he tosses the scalpel aside. Whimpering with pain and frustration, he pounds the edge of the bathtub with his fist. He shoves the magnifying lamp out of the way and sits there gasping and clenching his fist. House slowly picks up his phone and scrolls through his phonebook with shaky hands.
Wilson is asleep in bed at his apartment. His cell phone is on the nightstand next to the bed. It vibrates multiple times and a picture of House pops up on the screen, Wilson stirs in his sleep, but does not wake up.
At the strip club Taub is now paying close attention to the dancer. "Your lap is vibrating," the stripper says moving away from his lap and slowing down her dancing.
"Oh, sorry," Taub says. He takes his phone out of his pocket to see who is calling. "Uh, it's my boss." He puts the phone back in his pocket. "Probably drunk. Wants a ride home. He can take a cab. Do you have any kids?"
"Why? You like moms," the stripper asks as she continues to dance for him. "I could be your mommy. Spank your little ass." She grabs hold of Taub's tie and twists it. He looks embarrassed.
"Mmm, uh, no," Taub responds. "I…what would you do if you got pregnant? Not by me… at all, but by some hypothetical guy who didn't want to keep the hypothetical kid. What would be the least awful way for him to tell you that?"
"Don't talk," the stripper says. "Just let mama dance for you."
"Should I send flowers," Taub asks. "Maybe write the clinic appointment on the little card? Surprise! I hate myself." He sighs. "There's just no good way to…" he trails off noticing a mole on her lower back. He reaches out and touches it. "How long have you had this mole," he asks. "It's asymmetrical."
The stripper slaps his hand away. "No touching."
"Sorry," Taub replies. "Have you been to see a dermatologist?" He fidgets for a second and unable to help himself he reaches out again.
The stripper slaps at him and calls to the bouncer, who comes right over. "Bobby!"
Taub looks at Bobby as he enters the room. "Oh, uh…I wasn't touching her," Taub stammers. "I was just…oh, God." Bobby grabs Taub by the lapels and practically picks him up off the chair. "Oh!"