Author's Note: How do you know that you know what you know?
Disclaimer: I don't own House, M.D., nor its concepts, characters, and setting, but I do love them, especially Chase. This story is for entertainment purposes only and is not meant to take the place of the advice of either physicians or lawyers licensed to practice in your country or state.
He had gone from divinity to medicine to epistemology. He had to prove to the Americans that he knew what he knew. Cuddy had assigned herself the task of making sure he succeeded in proving it. She had him walk rounds with every department in the hospital, shadow every doctor who would tolerate his presence. They reviewed every piece of equipment in the hospital, every procedure he'd ever done, every procedure she thought Dr. House might ever want him to perform in the future, endless policies, protocols, and differences in terminology until he thought his brain would explode.
Still, Chase was no stranger to hard work, nor to study, and unlike the residents and interns, he already had a wealth of experience to draw from, plus the luxury of returning to the relative privacy of the Diagnostics Department office periodically, to drink coffee and pour over textbooks and journal articles in peace. House was almost never there in the mornings, and in the afternoons he retreated to his private office to watch his soap opera, or bounce his big tennis ball off the wall, but at other times, he would come into the outer office to drink the coffee Chase had made and read in companionable silence.
It was weird, the Australian doctor thought, that House made no demands on him at all, but Chase's plate was so full already, he decided he'd worry about it later, if there were a later.
Faint, but still detectable over the antiseptic with which the exam room had been cleaned, lingered the aromas of both a heavily perfumed body wash and the pungent stink of skunk.
"Go ahead, Dr. Chase." Cuddy handed him the chart and waved him towards the waiting patient.
It was the first time she had allowed him to do more than observe, but he'd seen plenty of patients back home. He accepted the chart and smiled at the patient, a thin young woman in her 20s, her hair still damp from a recent shower.
"I'm Dr. Chase," he introduced himself, then gestured to his boss, where she'd seated herself unobtrusively near the door to observe, as some other physician must until he was licensed. "This is Dr. Cuddy."
The patient nodded a greeting. "Sativa Marley."
"What brings you to see us today, Miss Marley?"
"I've started vomiting again."
"Again?"
For the past several months, she'd been experiencing cyclical episodes of vomiting. For days at a time, she'd be throwing up, as if she were taking chemotherapy, except she wasn't. She was perfectly healthy. So she'd gone to the doctor. He'd advised her to take Kaopectate or Pepto-Bismol.
"Bismuth subsalicylate," Cuddy interjected for Chase's benefit, in case he wasn't familiar with those brand names.
Chase nodded to show he understood, but kept his eyes on the patient. "Did it help?"
"No."
"Then what happened?"
"After a few days it stopped, so I figured it was just a bug or something and that I was fine."
He heard Cuddy move restlessly behind him. No surprise there, she typically interrupted patients after the first 22 seconds. Chase gave Miss Marley a few more seconds before prompting, "And were you fine?"
"No. Two months later, it happened again. Days and days of puking and puking, so I went back to the doctor. He ordered some tests, and proscribed Anzemet."
"Dolasetron," Cuddy said.
Chase nodded again. "Did it help?"
"No. It just gave me diarrhea. And the tests were negative. No gallstones, no infection, no Hepatitis, no colitis…. But then it stopped again, so I figured I was fine."
"And were you?"
"No. Six weeks later there I was throwing up again. So back to the doctor I went."
Behind him, he heard Cuddy clear her throat. He ignored it.
"This time he gave me Dramamine."
Cuddy was silent. Apparently, she correctly supposed he'd seen a few American airplane disaster movies in his time, so couldn't fail to know what Dramamine was.
"Did it help?"
The patient laughed. "Of course not! More tests! All negative —no ulcer, no obstructions—but then it stopped again, so I figured I was fine."
Chase smiled at her, but didn't say anything. No need.
"A month later it happened again. And here's a joke: he suggested I try some marijuana." She shook her head ruefully. Her hazel eyes had dark circles around them. "I'd already been smoking every day. But it didn't help. Nothing did, except—"
"Hot showers," Chase said.
Miss Marley stared at him in shock. "Oh, God, yes! Two and three a day! How did you know? Do you know what's wrong with me?"
Chase sighed. "I'm afraid I do."
"Oh my God, this is amazing! What is it?"
"It's called cannabinoid hyperemesis."
"Is there a treatment for it?"
He hesitated. "Yeah, well, there's actually a cure for it."
"Excellent! What's the cure?"
"Stop smoking pot."
"What?!"
"If you… stop smoking pot, the symptoms will go away and won't recur."
"But I know lots of people who smoke all the time, and they don't puke their guts out."
He nodded and sighed together. "I know lots of people who enjoy eating strawberries, but if I eat one I go into anaphylactic shock."
She caught the corner of her mouth between her teeth and worried at it for a moment. "No more pot, huh?"
"I'm sorry, no."
It was her turn to sigh. "Okay, thank you, Doctor."
"Welcome."
As he ushered the patient out, he saw Cuddy staring at him.
"I heard you diagnosed a patient with cannabinoid hyperemesis this morning," House greeted him when he returned to the Diagnostic Department after lunch.
"Yeah," Chase agreed.
"Cuddy said she'd never heard of it before, but I have. What was the tipoff?"
"The body wash and skunk smells. And no meds helped her, nothing but hot showers."
House smiled. "I think I like you."
Chase smiled back. "I think I like you, too."