Chapter 28

While House was dealing with Jimmy Quidd and making his final decisions about his team, Issy started her first week on the oncology floor. It turned out not to be as depressing as she had feared. The floor was a bright colorful place; the walls painted in sunny yellow and sky blue. Their kitchen had the best snacks in the whole hospital and Issy was surprised that House didn't realize that. They even had Creamsicles and Klondike bars in the freezer. The kids had a great playroom at the end of the pediatric wing and the nurses were surprisingly upbeat and cheerful.

Issy was teamed with Sophia for the first part of the week. Sophia was a short Latina woman who wore thick eyeglasses and kept her long dark hair pulled back in a bun. She took her job very seriously and was quick to speak her mind if there was a problem with one of her patients. The man in room 523 was throwing up and the anti-nausea medicine hadn't arrived yet from the pharmacy? Sophia was on the phone calling them. Doctor ordered a questionable dose? She was double-checking the dose with the pharmacist before you could turn around. A small wince or grunt from a patient and she was inquiring about the patient's pain level. If the current dosage wasn't keeping the patient's pain down to a tolerable level, Sophia was on the phone speaking to the doctor about upping the dose or trying a different med. Sophia was never rude in dealing with the doctors or pharmacists; she was just efficient and brisk in her mannerisms and usually ended her long discourse with 'you know what I mean, babe?' She was a real patient advocate and Issy learned a lot from her in just those three days.

On Thursday, she was rotated over to the pediatric side of the floor. She was a bit nervous about dealing with the 'bald-headed kids' as Greg called them. It was hard seeing such young children going through these rough treatments, and yet, if they weren't too sick, they were just like any other kid. They spent time in the playroom; they had art therapy. Volunteers read them stories; clowns and other entertainers visited the floor. In some ways, it was a happy place, except for the puke buckets and the occasional visitation from the Grim Reaper.

Issy was teamed with Kristin, a young energetic woman in her early 30's. She introduced Issy to each of their three patients as they made their early morning medicine rounds. Before they went into each room, Kristin gave Issy a quick run-down on the type of cancer that the child had, his or her current status and the things that they liked to do. She explained that she liked to engage the children in conversation about their favorite things as it helped to take their minds off of the treatments.

Right before they walked into the last room, Kristin said: "This is Davey. He's five years old and is very into Batman. He is having chemo today. Dr Wilson is giving him intrathecal methotrexate for his leukemia and Davey is very anxious about it. He hates needles and always wants you to tell him about many 'sticks' he is going to have before you start the procedure and count them down during the procedure. Dr Wilson will need our assistance later to administer the chemo. Have you met him yet?"

Issy nodded: "Yes, I have." She didn't go into any further details.

"Isn't he nice? And he is so good with the patients."

Issy just nodded with agreement as they walked into Davey's room. So far this week, she had only seen Dr Wilson from a distance; she hadn't had a chance to interact with him at all. Guess that would change today.

The little boy was sitting up in bed with the bedside table pulled over his lap. His still full cereal bowl was pushed aside as he used the remaining table space to play with his Batman figurines.

Kristin said brightly: "Good morning Davey. I want you to meet someone. This is Issy. She's a nursing student here and she's going to be helping me today."

Issy said in an equally bright tone: "Hi, Davey."

He glanced up at her and then back down at his action figures. "Hi."

Kristin continued on: "You didn't eat your breakfast? I thought you liked Cheerios. Want some Frosted Flakes or Fruit Loops instead?"

The small boy mumbled: "I'm not hungry."

"I could make you some eggs or a grilled cheese sandwich."

Davey just shook his head; he placed Batman into his Batmobile and started zooming the car around the table.

Issy piped up: "You want me to get the bowl out of Batman's way?"

The child looked up at her and nodded. Issy grabbed the bowl, took it out into the hallway and set it on the food service pickup cart. Davey was zooming the Batmobile all over the tray when she returned, but he paused long enough to give her a brief smile.

Kristin said: "Well, maybe you and Batman will be hungry for lunch. I hear there's a choice between spaghetti-o's and chicken fingers."

Davey ignored her and continued playing with his action figures.

Kristin checked his pulse, made an adjustment to his IV and then said: "Davey, do you remember what today is? Dr. Wilson is going to give you the chemo in your spine today."

His lower lip trembled: "How many needles is that?"

"I think it is just the one needle, but you'll have to ask Dr Wilson to be sure. He should be here soon. Do you want me to get you anything now?"

He shook his head, lower lip jutting out in a pout.

Issy asked: "Does Batman need anything?"

Davey pondered for a moment and then said: "Batman needs a juice box. He wants grape."

Issy nodded: "OK. I'll go get him one."

Kristin smiled at her cleverness in getting Davey to state what he wanted. Issy ran out to the kitchen and grabbed two grape juice boxes, just in case Batman was really thirsty. She returned to the room just as Dr. Wilson was approaching the door. He gave her a friendly smile and motioned her to enter in front of him.

As he walked in, he said: "Hi Kristin. Hey, Davey. Did Batman catch the Joker yet?"

Davey merely shot Dr Wilson a look.

Wilson plopped down in the chair next to the bed. "Oh, oh, someone doesn't look happy to see me."

Davey whined: "How many needles this time?"

Wilson held up one finger. "Just the one. First I'm going to rub this cream on your back and numb the spot. Then I'll put one needle into your skin. All the other needles will go into that one and you won't feel them. OK?"

Davey looked suspiciously at Wilson, but nodded anyway.

"You're going to need to lie on your side for this, just like we did last week. I'm going to need to move this table now. Do you want Batman on the bed with you?"

The child grabbed Batman, still sitting in his Batmobile, and clutched him to his chest. After a nod from Wilson, Issy moved the table out of the way.

"Davey, I need you to roll over onto your side with your back to me.

The boy slowly rolled onto his left side and presented his back to Wilson, who parted his gown, exposing his back. "The cream will feel a little bit cool on your skin. Ready?"

Davey nodded and Wilson proceeded to apply the cream. Kristin then handed Wilson a sterile drape with a square hole in the middle of it. Wilson placed it over the boy's back with the hole positioned over the lumbar spine, where he would do the intrathecal injection.

Wilson addressed Issy: "Have you ever seen an intrathecal injection before?"

Issy shook her head.

He went on: "The procedure itself is sort of like a lumbar puncture. It's just instead of taking spinal fluid out; we're putting the chemo in. It's a relatively quick procedure."

Davey's tone was pleading: "And only one needle, right? You said only one."

Wilson gently rubbed Davey's upper back. "Only one, Davey. I promise. I'll warn you before it happens and you can hold Issy's hand if you want."

Davey mumbled something but they couldn't make it out. As Wilson opened his mouth to ask him what he had said, Glenda, the nurse tech, walked into the room carrying a white plastic bag. "Davey's chemo is here, Dr. Wilson, and Kristin, Tommy needs you next door. His IV pump is beeping away."

Kristin said: "Oh, maybe you can get one of the other nurses to look in on him. I need to help Dr Wilson here."

Wilson said: "Oh, go ahead, Kristin. Issy and I have got this."

Kristin looked surprised: "Are you sure, Dr Wilson? I can get."

He interrupted her: "No, really, we'll be fine. It's not a complicated procedure and I'm sure Issy will do just fine."

Issy wasn't sure what she had to do to help Dr Wilson, but she figured that he would tell her. She nodded at Kristin to let her know that she'd be OK.

Kristin said: "Well, OK. If you need anything, just holler. I'll be right next door."

Wilson reiterated: "We'll be fine."

With a slight sense of reluctance, Kristin followed Glenda out of Davey's room.

Wilson looked at Issy and said: "While we are waiting for the cream to work, here's what I need you to do. Get me a pair of size large gloves and then put on some gloves yourself. Once you are gloved, put a drape over the bedside table and take the methotrexate syringe out of the bag for me."

Issy followed his instructions to a 'T' and then moved the table closer so that he could reach the syringe when he was ready for it.

Wilson said to Davey: "Are you ready, Buddy?"

In a very reluctant tone, he replied: "I guess so."

"OK, I need you to curl into a ball with your knees to your chest, just like you did the last time."

Under Wilson's instructions, Issy helped Davey get into the proper position. She had one hand on the back of his head and the other behind his knees to keep him in the right position for the needle stick.

Wilson swabbed Davey's back with betadine and then said: "OK, Buddy. This is it. One stick and that will be it. Hold very still for me."

He mouthed to Issy: "Talk to him."

Issy thought quickly and then said: "Hey Davey, what do you think would happen if the Joker and the Riddler and the Penguin all ganged up on Batman at the same time?"

As Wilson eased the needle into Davey's spine, he made a small grimace of pain and then said: "Batman would still beat them all."

"Really? All three of them at once? Wow, he really is a tough guy, isn't he? What if Catwoman was there too?"

Davey replied in a disgusted tone: "Catwoman is a girl. Batman can take care of her."

"Well, for a girl, she's pretty tough. She's got that whip too."

As the two of them discussed Batman and his foes, Wilson quickly injected the chemo drug into Davey's spine. He was pleased at Issy's way of distracting the child from the procedure.

"OK, Davey, it's all done. I'm taking the needle out now. Small pinch. There, that's it. Now I need you to lie on your stomach for an hour so that the medicine can move up your spine. Remember you did this last time too. One of the nurses will come and tell you when an hour's up, OK?"

Davey begged: "Can Issy stay with me?"

Wilson looked surprised. Davey rarely asked for anything and he certainly never asked for anyone. His mom was a single parent and overwhelmed with dealing with her sick child, two other children and a difficult job. She was rarely here for his treatments and little Davey had to tough them out on his own. Somehow, he seemed to know that his Mom couldn't be there for him and he rarely asked for her.

"Of course, Issy can stay with you."

Issy looked up at Wilson with a questioningly look on her face.

He waved his hand at her. "I'll tell Kristin; it will be fine. Just keep him on his stomach for an hour and then he can roll over onto his back or side. By lunchtime, he'll be able to sit up to eat. If he sits up too soon, he could get a headache so that's what we are trying to prevent."

Issy nodded and glanced at the clock, noting the time.

As Wilson walked out of the room in search of Kristin, he heard Issy say: "So, Davey, who do you think is Batman's toughest villain?"

Over lunch that day, Wilson told House about working with Issy. "She was really great with that kid. Kept him distracted while I did the intrathecal. She should consider peds as a specialty. She knows how to talk to them."

House swiped a fry off of Wilson's plate. As he munched it, he said: "I don't think she's really into kids. Just cuz you can talk to them, doesn't mean you want to work with them day after day. The only specialties that she's mentioned to me are ER and ICU."

"They have certifications which means more money. Is she chasing the money?"

House shrugged: "More money is better than less money."

Wilson nodded slowly as he chewed a bite of his tuna fish sandwich. Suddenly he asked: "Did Issy grow up poor?"

House frowned and asked: "Why do you ask?"

"She seems very money conscious, rather unlike the other women I've seen you date. I've seen her give you back your change from the delivery guys and comment about things on sale at the grocery store, like you give a rat's ass about sale items. It just made me wonder."

House damned his keen observational skills. "She's had some tough times, let's just leave it at that."

In a sympathetic tone, he said: "She doesn't like to talk about it, huh?"

Brusquely he replied: "No, and neither do I."

He swiped the three remaining fries on Wilson's plate and limped away, leaving Wilson to bus both trays.

That night, with his own case solved and his team finalized, he asked Issy how her week in oncology was going. She filled him in on what she had learned so far and told him about helping Wilson with the intrathecal procedure today.

When she finished her tale, House said: "I had lunch with Wilson today. He told me all about it. Said you were really good with that kid. He was very complementary."

Issy looked surprised, but pleased. "Really? He said I was good?"

"He said, and I quote, you were really great and should consider peds as a specialty."

"Oh, that was nice of him to say that. But I definitely don't want to do peds."

He nudged her closer to him so that he could wrap his arm around her shoulders. "You don't like kids?"

"I like kids OK. I just think it would be too emotionally draining to be around sick ones all the time."

House nodded in agreement. "One thing you must learn is how to maintain a professional distance from your patients. You can't get invested in them. The nature of our professions is that sometimes, no matter what we do, patients die. We do everything we can to prevent it, but often it can't be helped. And if you want to work in the ER or in ICU, you'll probably see death a lot more often than if you worked, say, on the ortho floor."

Issy nodded: "You're right about that. I think I can maintain a distance though, I've kinda had a little practice at distance in my former occupation."

She blushed but continued on: "It's just that seeing kids die would be harder than seeing adults die, to me anyway."

He stroked her cheek: "It's harder for most people. It's our biology; we are programmed to protect the young. They are not supposed to die before we do; they need to stick around and take care of our wrinkly asses in our old age."

Issy let out a little giggle: "Yeah, that's true. Is that why you keep me around?"

His hands went to her ribs and he tickled her a little bit. "Are you saying my ass is wrinkly? Is that what you're telling me?"

He tickled her harder; she giggled as she squirmed to get away from him. "No, no, it's not wrinkly. It's nice and firm and sexy. Stop!"

He stopped tickling but tapped his fingers against her sensitive spots. "Sexy, huh? You think my ass is sexy?"

"Very sexy."

He gave a faux snort. "So you say."

"Want me to prove it?"

"Yeah, how you gonna do that?"

Issy stood and extended her hand to him. She gave him one of her sultry smiles. "Come to the bedroom with me and I'll show ya."

He stood and took her hand. "It might take a lot of convincing. My ass's feelings were hurt by what you said."

As they headed down the hall together, Issy said: "I think your ass and I can kiss and make up."