Loose Ends
Cameron sank into her chair, spinning around to face the office window. There wasn't much to see, just fat droplets of rain splashing against the glass. The sun had set about three hours before, around the time Wilson had confirmed her diagnosis of the ten-year-old boy that had come through the clinic with his mom three days before. At first blush it looked like a bad case of the stomach flu, except according to his mom, the bouts of vomiting had been ongoing for more two months, and the nausea for quite a while longer. In addition, over the last several months Josh had lost almost ten pounds.
So Cameron asked more questions. Twenty minute's worth. Several options crossed her mind. Gall bladder (awfully young), stress (no problems at home or school, according to Josh and his mom Sylvia—in separate interviews just to make sure she was getting straight answers—and he didn't seem like an anxiety ridden kid, outside of the fact that he felt like crap), food allergies (his mom hadn't had enough time to start an exclusionary diet), appendicitis (no temperature spike and while his abdomen was tender, she was pretty sure his appendix hadn't migrated to the general vicinity of his liver).
It was the tenderness that caught her attention. Granted, vomiting and dry heaves over a 24-hour period accounted for a certain level of discomfort, but when she palpated the area of his liver, the pain level ratcheted up to a "hey, that really hurts" level.
She apologized to Josh, got him settled more comfortably on the examining table, and smiled at Sylvia. "Your pediatrician's probably right, just a bug that's gotten awfully fond of Josh's belly. But to be safe, I'd like to run a few tests."
Cameron hadn't thought it was possible for the boy's face to turn an even paler shade of gray. Seeing his reaction, Sylvia explained, "Josh has a little problem with needles."
Cameron hesitated for a moment. She didn't want to put a tired, frightened, and needle-phobic child through any more pain just to cover her ass, but the abdomen pain could not be overlooked.
"Yeah, that part's not much fun. But I'm really good at it, I promise. You'll hardly even notice." Josh gave her a weak, but brave, smile and she left the room in search of House.
Surprisingly he gave her very little grief about her desire to pursue the case, putting her through her diagnostic paces for about two minutes before letting her off the hook with a brusque, "Let me know if you get in over your head."
She appreciated that he said "if" instead of "when."
A CBC, liver function test, tumor marker, ultrasound, and MRI later, Cameron, House, and the rest of the team sat staring at the whiteboard. Wilson joined them, agreeing with Cameron's preliminary diagnosis--liver cancer. The next day, surgery and a biopsy of the tumor confirmed it. Hepatocellular carcinoma, stage three. Wilson couldn't remove all of the tumor with surgery. Chemotherapy would be necessary to shrink it, followed by more surgery. The prognosis was bleak.
She and Wilson delivered the news to Sylvia, Wilson saying very little, choosing to hang back and allow Cameron to talk softly to the devastated mother, who sat still as a statue in the ugly green post-op waiting room chair, as if she thought if she just didn't move, it wouldn't be real, like a field mouse spotted by a hungry fox.
Finally, in a frightened voice, she asked just one question, "Can you save him?"
"Dr. Wilson is one of the best. There's no one I would rather have handling this case. There's no reason to give up hope."
Sylvia was a pretty perceptive woman, after just three days with Cameron she knew how to read between the lines, and lowered her head, sobbing quietly. Cameron held her hand, feeling utterly useless until Wilson squeezed her shoulder reassuringly, gave her a gentle smile, and silently left the room.
After taking Sylvia to the recovery suite to see Josh, Cameron caught up with Chase and Foreman as they were heading out for the night.
"Tough case kiddo," Foreman said affectionately. "Up for drowning your sorrows at the pub?"
Cameron shook her head, but smiled her appreciation at the offer. "I'll trust you two to drink my share. I'm going to catch up on some paperwork and head home."
Foreman looked like he wanted to try to change her mind, but followed Chase out the door with a last worried glance over his shoulder.
Fifteen minutes later, not one shred of paper had been pushed. She hadn't even managed to turn away from the hypnotic, dark rain falling against the window. House's familiar step-thump, step-thump as he entered the room hardly registered. When she failed to acknowledge him, he not-so-subtly cleared his throat to more formally announce his presence.
Reluctantly she turned her chair around. She watched him study her face, trying to gauge her mood. She offered him as blank an expression as possible, and began shuffling random papers on her desk, hoping he'd take the hint.
And instead, he dove right in. "Wilson filled me in. It was a good call."
Cameron nodded, and began doggedly opening the pile of envelopes that had piled on her desk over the last two days.
"How's the mom?"
She stopped, wondering if she'd heard him correctly—asking after a patient's family. Deciding she had, she answered truthfully, "Devastated. Trying to stay strong for Josh. Mostly, blaming herself."
"And you told her…?"
"I told her that it wasn't her fault," Cameron answered sharply. "And then I told her if it was anyone's fault, it was her idiot pediatrician and the ER docs who ignored Josh's symptoms for the last two months."
Few things surprised House, but Cameron's last sentence earned her a raised eyebrow.
Which was all the further he got. "Please, do not lecture me about how ill advised it is to question the work of another doctor," she said before he could say a word. "The pediatrician saw Josh three times over the last six weeks, each time recommending Pepto Bismol and chicken soup. Evidently the moron likes to think of himself as a traditional no-nonsense country doctor. No reason to get too worked up about the typical childhood problems, like you know, liver cancer."
By this time Cameron was standing, hands on hips, her eyes daring House to push her. House, on the other hand, was relying on every bit of his self control to keep a grin from spreading across his face. He'd never seen her so pissed off about anything, including his often completely inappropriate treatment of her, the rest of the team, and patients. He found it oddly endearing.
"Let me buy you a drink," was his response.
Her's was to gape at him, and then open and close her mouth like a fresh caught bass, trying to come up with an appropriate response.
He did it for her. "Now that's attractive. C'mon, you look like you could use a post-bad-news-giving cocktail, if you can keep your mouth closed long enough to swallow. Seriously, that's freaking me out."
Cameron clamped her mouth shut and followed House mutely into his office where he reached under his desk and pulled out a bottle of Kettel One vodka from the mini-fridge under his desk. Two rocks glasses appeared as well. After a generous pour in each, he handed one to her. She accepted it and wandered to the back of his office, sitting down on the tiny sofa, again finding her attention drawn to the dark rain outside.
Several minutes later found her in the same position, quietly sipping her drink. House was tempted to nudge her into another tirade by asking another question about her lawsuit launching speech to Josh's mom, but thought better of it, and instead watched her watching the rain.
"I don't want to be here," she said quietly, almost to herself, breaking the comfortable silence.
"Define 'here'" House said. "Here in this room? This hospital? This plane of existence?"
"This job," she answered sadly, her voice just a whisper.
