"We have a referral from the ER," Hadley said excitedly as she rushed into the diagnostics conference room waving a patient's chart in the air.
Taub and Foreman joined her at the conference table. "OK," Foreman said, "give us the details."
Hadley tucked a sleek strand of her long, brown hair behind her ear and summarized the patient's history. The patient was a 35 year old male with who had been brought to the PPTH ER by ambulance after he collapsed at work. His colleagues reported that he had been in a bad mood, and shortly before his collapse was confused about where he was.
"His temp is 105, he has a stiff neck and photophobia," she reported.
"He has meningitis," Taub said with a bored and disappointed tone.
"The ER doc suspected meningitis, but the spinal tap is clean," she said placing the open file on the table in front of Taub and Foreman.
"Aseptic meningitis is probably viral," Foreman said.
"Negative for CMV, negative for varicella, negative for HIV, and negative for West Nile" she listed the viruses for which the patient had already been tested.
"Hmmm," Taub said. "Where's the patient?"
"They're sending him to intensive care quarantine, and referring him to us."
"Well, let's go through the differential and then we'll go meet the patient," Foreman said as he grabbed a dry-erase pen and stood at the whiteboard.
Downstairs Cuddy escorted an elderly couple out of her office smiling graciously.
"We really want to see this happen, Dr. Cuddy," the man said as he placed his fedora over his snow-white hair.
"So do we, Mr. Nilsen, and the hospital sincerely appreciates your generous support."
The Nilsens were there to give a sizable donation to support a community-based hospice program that would enable terminally ill patients to spend their last days in their homes while simultaneously providing hospice and palliative care training opportunities for medical and nursing students.
Mrs. Nilsen took Cuddy's hand between her own and looked earnestly at the younger woman with eyes that looked almost cartoonishly large behind her extremely thick eyeglass lenses. "The hospice in Plainsboro is a very nice place, but my sister wanted to be at home. We only wish that we could have done this sooner."
Cuddy nodded sympathetically. "We will definitely send you a progress report on the program."
Mr. Nilsen wrapped one arm around his wife and they walked together, leaning on each other, through the lobby and out the exit doors.
As the Nilsens exited the hospital James Wilson re-entered. He walked across the lobby to Cuddy's office.
Cuddy had already returned to her desk, so she had not seen Wilson return. When he knocked on her office she looked up and then looked at her watch.
"You didn't have to come back today," she said kindly, noticing how tired he looked.
"Thanks, I have to finish some paperwork and I'm taking the day off on Wednesday."
She nodded understandingly. Wednesday would be the anniversary of Amber's death.
"So...?" Cuddy asked.
Wilson sat in one of the chairs in front of her desk. "It's going to be a slow process, but like you said, he's really making an effort."
She nodded.
He combed his fingers through his straight, dark brown hair. He added quietly, "He feels guilty that he couldn't save Amber."
Cuddy nodded again. She actually suspected that was the case, though she doubted House would ever admit it to anyone including himself. She had encouraged House to reach out to Wilson out of hope that they could help each other heal from Amber's tragic death.
"I think he's letting it go," Wilson said rubbing his hands over his face.
Cuddy thought Wilson was talking about himself as much as House. They had all been affected by Amber's death, of course, but none more so than Wilson, who was clearly deeply in love with her; and House, who very nearly gave up his own life to save her. But, in Wilson's case it wasn't just Amber he was letting go, but his complicated feelings about House's involvement in the situation that lead to her death.
What Cuddy worried about more, but did not express to Wilson, was how Kutner's suicide impacted House. So many people assumed that Eric Foreman was most like House, and they were wrong. The similarities between House and Foreman were quite superficial. Kutner, on the other hand, was very much like a younger version of House. Cuddy had watched House's tortured struggle to make sense of Kutner's suicide, and worried that its impact, compounded by his denial that it had any impact at all, left psychic wounds that contributed significantly to his decline.
Wilson interrupted her thoughts, "Are you going out there again this week?"
"Yes, I told him I would." She thought it was important to keep her word to him.
Wilson nodded. He knew that House needed them. House would never admit it, but Wilson thought he and Cuddy provided a thin safety line that tethered House to his real life and kept him from sinking further into the depths of addiction and despair.
Upstairs in the diagnostics conference room, the patient's symptoms were neatly written on he whiteboard. Foreman lead the team through the differential. In the absence of bacteria or viruses meningitis could be caused by fungi, or cancer. They would have to talk to the patient and conduct more tests.
"I'll go talk to the patient. You two can determine if there is enough CSF from the spinal tap for additional testing. I'd like to avoid doing another tap unless it's necessary."
Hadley was surprised that Foreman was sending her off with Taub. Taub was a little surprised as well. Clearly Foreman was making an effort not to display any sort of favoritism towards Hadley.
Foreman wasn't thinking about favoritism at all. He was thinking about leading by example, meeting the patient face-to-face and taking the patient's history himself.
The three doctors exited the conference room and walked to the elevators together. They seemed to be doing just fine without House, Foreman thought smugly.