Chapter Twelve - Diagnostics with Professor House
Across the carpark of Princeton Plainsboro Teaching Hospital, Greg House limped the short distance between his car and the main entrance. The relentless heat that had persisted all week had refused to let up. So much so that he had forgone his usual morning coffee in favour of an iced tropical beverage he'd picked up en-route to work; it was already half melted. Stepping inside, the first thing he noticed was that the air-conditioning had been repaired overnight and thus made the building a more attractive prospect than the outside world. He'd wager the clinic would be packed full of people pretending to have heat stroke, but in reality just wanting to escape the sun's continual bombardment.
Striding across the ground floor, he reached the elevator and rode it up to the fourth. When he passed the door to Wilson's office he made a mental note to find some way of pranking him should he get a free moment. Through the windows of his outer office he could see that his team had already gathered. The files in front of them suggested that they had successfully done his bidding and put Kiddo through the battery of tests. Opening the door, he stepped inside and took up his seat at the head of the table. He tossed a pair of vicodin from the bottle in his pocket and helped himself to a donut from the box in the centre of the table before acknowledging that he'd even noticed his team were present.
"Good morning class," he said before taking a bite out of the donut. "I hope you all did your homework." He made a hand gesture that indicated he wanted a copy of the test results.
Chase raised his eyebrows in a sort of gesture that told House they had been discussing how best to give him the results. He slid the now slightly fuller file across to House.
"We did, but you're not going to like it, all the bloodwork came back clean. The rapid strep test was negative and the lung function test was normal." He sat back and sipped from his own coffee cup and loosened his tie.
"Hey, who said I was against negative test results. In fact, the Michelson-Morley experiment produced one of the most famous and biggest theory shattering null-results of all time." He waited to see if any of his students had done their physics lessons.
Ignoring House, Foreman added the MRI scans to the top of the file. He adopted his neurologist tone, "there's evidence of a significant head injury, a small hairline fracture would have been my bet. She would have been ill, possibly vomiting and had a major headache, possibly some visual disturbance too, but it's healed and wouldn't explain anything current."
House shook his head in disappointment. "Ten points from Gryffindor," he declared, pulling the MRI scan out of the second file and holding it up to the light. He squinted at it in an unimpressed sort of way.
"Sorry professor Snape. Looks like she's healthy," Chase said reaching for a donut.
Cameron, the one who had actually run all the tests by herself, had removed her lab coat and was in the process of trying to open the window. It appeared that while the majority of the hospital's air conditioning had been repaired, the one in House's office was still woefully neglected. "Her fever is down. Breathing normal." She sat down and checked her pager. "Which is more than I can say for my other patient who took another attack this morning."
House reached out with his cane and hooked the box of donuts out of Chase's reach. "While Dr House doesn't mind negative test results, Professor Snape doesn't reward students that don't bring something meaningful to the table," he paused for a moment, feigning contemplation. "In fact, he has a tendency to punish those not in his House. Detention, Dr Chase… and by detention I mean you just earned yourself three of my clinic hours for the week."
Cameron reached over and firmly took her box back from House's grasp. She handed one to Chase and standing took the box to the counter. "Apart from spikes in her heart rate and temperature she's perfectly fine today. Head wound is fine and a mild concussion. But we had a thought…" she glanced at her coworkers.
Foreman rolled his eyes as if he knew he would end up being the one to deliver this in their earlier conversations. "We think that the initial diagnosis is correct. She had an anxiety induced asthma attack and despite what I said initially the fever is connected to it, she is having a physiological response to stress." He paused and watched Cameron and Chase a moment. "Probably exasperated by you."
"Yeah, because the collection of Doctors wandering about the place dressed like… well, doctors and all the other hospitally things did absolutely nothing to set of her iatrophobia."
Cameron looked confused. "What iatrophobia?" She asked.
House rolled his eyes. "Seriously, Cameron, you're supposed to be the caring one and yet you failed to notice that she had iatrophobia. Why do you think I said only you could go near her?" House mockingly held his mouth agape and made a hand gesture that indicated that the others should join him in his shock.
While Cameron stuttered her reply Foreman raised one eyebrow and looked sceptical. "Do you know how rare true Iatrophobia is? Her psychiatrist would have mentioned it in his files. She was perfectly calm more or less with Cameron today. I'd say she was playing you."
A stony look followed Foreman's suggestion that Kiddo had played him. "Firstly," he turned to look at Cameron, "you've got detention too for your failure to do the one thing you're good at. And by detention I mean…"
Cameron crossed her arms and sighed before cutting him off, "yes, I know what detention means."
House continued as though the woman had not uttered a word. "Secondly, do you know how rare physiological manifestation of stress as fever is? There has been no epidemiological study of psychogenic fevers, yet. Therefore, the number of affected patients is unknown. It's only in a few lesser known, lesser reported Japanese studies that the idea of functional hyperthermia is even being postulated. To have a working example of that, when many doctors still consider it to be nonsense, would be groundbreaking in terms of research." He paused to give Foreman a piercing stare. "Are you suggesting we have a rare, Virgince in the medical field with a rare phobia, an even rarer stress condition? Or are we to throw out the rare phobia and replace it with the rarer still ability to put both her heart rate and temperature up and down at will? Assuming you still want to go with the, 'she played me', argument."
Chase looked up from the file he had been flicking through. "Her blood type is AB negative if that helps…" he said as though he felt he needed to make some sort of contribution to the current discussion now that his donut was finished.
"Wait, say what now? Does this now make her rare squared or something?" House mocked, although he knew the math on that one. Only one percent of the US population had that particular blood type.
"Anyway!" Cameron stated. "Her tests are normal, she's responding to painkillers and the nurses didn't report anything unusual about her observation…" she looked at House. "...except from you being there for 5 hours of course."
Chase shrugged and closed the file. "I say let her finish her observation period and go home. Rest at home and come back if the head wound causes any issue."
Foreman watched House carefully for a response.
"Wow," House exclaimed, feeling a little like rolls had been reversed on this occasion. "Usually I'm the one pitching the rare theories for you guys to try and debunk." He took a second bite out of the donut he had sorely neglected and conditioned with his mouth full. "Are the three of you actually saying you think this kid takes stress related fevers and that we should just let her go home?"
Foreman held his hands palm up and shrugged. "It's the only logical explanation. Idiopathic fever is the other, which we know you don't like. We can put that down on her discharge papers and give her a reliever inhaler away if it makes you feel better. But all of her blood work is negative. No infection, no symptoms, nothing to go on."
"You know you could have just said yes, Professor," House replied with a shake of his head. "I guess it's detention for all three of you. Unless one of you wants to go and deliver the good news to the patient?" He looked at each of his fellows in turn.
"Detentions fine with me, the clinic air con is working," Chase replied and got to his feet. He pushed the file into the middle of the table, turned and walked to the door.
Foreman gave House a 'no thanks' sort of look and followed.
"Aren't you naughty boys going to wait until teacher dismisses you?" House said, shooting a look that dared either one to walk out the room without his permission.
Cameron smiled slightly. "Since you were the one that wanted her case it's only fair you get to deliver the good news and do her discharge checks. You have the best rapport with her after all. She actually speaks to you from what the nurses said. The most I got out of her this morning was polite Indignance." She reached out and gave his shoulder a slight squeeze as if sympathetic and turned to head for the door too.
"Before you all head off to the detention hall, there's one last little matter we need to discuss."
All three fellows paused to look at their boss, it was a weird reversal of situation. Leaving House to go deal with the patient while they went to the clinic was not something they revelled in...well maybe slightly. With a glance between them they looked back blankly at him for more information.
House gave them all a wiley grin before honing in on Foreman. "I got a lung function test, an MRI, a strep test and a full set of bloodwork out of her. Not to mention the five hourly vitals checks I carried out and the examination of her back and lungs," he paused as he started counting his fingers, "that's at least nine-hundred smackeroos you owe me." His grin became insufferably smug.
The neurologist scowled darkly and with a disgusted shake of his head fished in his back pocket for his wallet. He rummaged through the notes there and withdrew the lot save for one or two small bills. He dropped the money unceremoniously in front of House and folded his now depleted wallet and stuffed it back into his pants. "I've got four, that's all you're getting." He then turned and stormed from the office without waiting to be dismissed.
Chase hurried after him. The phrase "You know...part of me wonders if they were in on this together…" in a consolatory tone was heard as the door shut,
Stopping at the door, the only one left in the office, Cameron turned to look at him. A wave of nervous awkwardness coming from her, she cleared her throat.
"Looking for some extra credit," House asked as he scooped up the stack of bills and put them inside his now bulging wallet. He'd made six hundred dollars in less than twenty-four hours and only at the cost of a few scuffs to his phone. Hell, he could buy a newer, better phone and still have enough change for a decent bottle of scotch and some lavish takeout.
"what you said...on the phone...about getting to know you better…"
He looked Cameron up and down. Young, sexy and above all emotionally clingy. A shame really. If she'd been the party sort of girl he might have considered inviting her back for the hypothetical takeout and bottle of scotch. Unfortunately, she would read too much into the evening… wonder why he didn't call next day… get outraged when he told her it had meant nothing and, worst of all, become absolutely useless to him as a doctor. No, she would be best kept as the piece of art that he could look at every once in a while, but never own. A painting on loan from the national gallery perhaps.
He got up from his chair. "Sorry, my social calendar is surprisingly full of bowling with Wilson, poker nights, and sitting on my ass at home doing bupkis," he replied and brushed past her out of the office.
Cameron's expression fell as he spoke. Her jaw clenched around the emotion his words purposely stirred. She said nothing as he passed her.
After a few steps he called out over his shoulder, "maybe I'll call you if I get an opening between my next hooker and crate of beer." With that he headed off down the corridor and towards the elevator. Time to go teach his next class.
Cameron for her part did not leave the office. Simply watched him go and took advantage of the empty room. She sat back in her chair and told herself that she was a big girl and that he was an ass. A blatant freudian ass.