"A twenty-year-old white male walks into the clinic complaining of a sudden onset of swallowing difficulties and hoarseness. What do you do?"
"I collect a history of the family and of the illness."
"What do you learn?"
Cameron doesn't need to glance at the pre-prepared charts in her folder. She has them memorized cold. Her voice is steady and calculated.
"He hasn't abused his vocal chords lately – no yelling, no screaming. He doesn't smoke and hasn't been exposed to any harsh chemical fumes. He doesn't complain of bad breath in the morning, which excludes nighttime acid reflux. He has no allergies to explain the hoarseness or swallowing difficulties. No running mucus, headaches, fever, cough, or facial swelling - so no URI. He's too young to have a history of external neck irradiation. There's no family history of cancer or any other genetic illness that would explain his symptoms."
"You've collected his history. Now what?"
"I take a look at his throat."
"What do you find?"
"I find a small, firm nodule at the base of his neck. Highly palpable. But throat nodules are fairly common in people who speak professionally or even people who yelled too much when they were children. I must differentiate a benign nodule from a cancerous, solitary, thyroid nodule."
"What's his job?"
"He's still a student."
"So your patient was just a cry baby?"
"It's possible. But it could still be something else."
"What do you do next?"
"I collect a throat culture and blood count."
"What do the tests tell you?"
"His blood count is normal and his culture is clean."
House nodded gravely. "That's the only information in your little manila folder there. From here on, you're on your own."
Cameron willed herself to swallow. House continued.
"Dr. Cameron your tests are inconclusive. What do you do?"
"I perform a non-surgical fine needle biopsy."
"Good. The test aspirations are malignant. It is cancer. Obviously not inherited. What does that tell you?"
"The patient could have one of many types of thyroid cancers. Papillary, follicular variant of papillary, medullary, anaplastic, thyroid lymphoma…"
Cameron's brow knitted.
"What now?"
"I need to do surgical biopsy. Subtotal thyroidectomy. I remove the 'problem' parts of the thyroid and isthmus."
This patient. These words. They were too familiar.
"Your biopsy reveals that your patient has medullary cancer. What do you do?"
"I perform a total thyroidectomy."
When she had first received this hypothetical case, she had felt a sudden twinge of sadness.
"What are the characteristics of medullary cancer, Dr. Cameron?"
"Usually, female are more likely to have it than males. Men older than 50 are the most susceptible…"
But she had foolishly written it off as coincidence.
"Hmm. We seem to have a very special patient on our hands. What else can you tell me about medullary cancer?"
"Regional metastasis occurs early in the disease, spreading to the neck lymph nodes."
"And?"
Cameron's voice wavered.
"Spread to distant organs occurs late and can be to the liver, bone, adrenal medulla… or his brain…"
The last thread of control slipped from her fingers. Her entire body shook.
Her green eyes filled with tears. She fell silent.
House couldn't bring himself to look at the broken doctor who sat before him. Why had he done this to her? What gave him the right to pry into her past and so violently bring back all the pain she had experienced as he husband died?
Because this is how you work, Greg. You knew that when you first thought of the assignment – when you first dug up the information in hopes of pushing her away just like you've done to all the others.
But this was different from the other times. He had instantly regretted it when she had looked at him with her emerald eyes – eyes full of tears and desperate hope that he was not cruel enough to do such a thing. For the first time in his life, if he were able to go back in time and change things… he would…
He voice was soft. "Cameron -"
She leaped from her chair. Her eyes were dark and piercing. Her hair stuck to the damp streaks that ran down her cheeks.
"You…bastard…"
House gazed at her, stunned at his ability to be so cruel.
Her voice rose. "Is this fun for you?"
He was inhuman.
"Does this turn you on?" she screamed.
She broke into sobs. Her hair tumbled in front of her face like an auburn shield. Her shoulders trembled. Tear drops fell to the carpet, creating tiny dark pools beneath her.
Silence silenced settled throughout the room like a blanket of ice.
Allison Cameron finally forced her shoulders back. She brought her hands to her face and wiped her cheeks dry. She pulled her hair behind her shoulders and stared blankly into House's equally blank eyes.
"You're sick, Dr. House," she said as if diagnosing a patient. She threw the folder full of her husband's charts over the desk and into House's face. He ducked instinctively. The papers fluttered around him. "Very… very… sick."
She gathered her belongings and walked through the glass doors of House's office.
The parking lot was mostly empty. The few cars that were there belonged to staff stuck on the late shift or people without anything – or anyone – to go home to.
Cameron leaned against her car, every muscle too fatigued to function properly. Her mind was stuck in a vicious path, following her entire relationship with House. From when he first told her that she had received the job because she was "pretty"… to when he said the he did not like her…to when he took her hand into his own… to when he brought the memories of her dead husband back to haunt her…
"Hey, are you okay?" His voice broke her chain of thoughts. She looked at Chase wearily. He regarded her with a surprisingly genuine look of concern. He dropped his suitcase onto the concrete ground and walked toward her, his head lowered inquiringly.
"You're shaking all over…"
"I just need some sleep."
He attempted a light-hearted chuckle. "I'll say. You can barely stand."
Cameron turned toward the car door and retrieved her keys from her pocket. She brought the key to the lock, but her unsteady hands fumbled the keychain and it tumbled underneath the car.
"Damnit!" she cried.
Chase frowned. He bent down and handed them back to her.
"Hey, let me take you to your home. I'll give you cab fare to get back here tomorrow morning. But you shouldn't -" Chase sighed as he regarded his despondent coworker.
"You shouldn't drive like this, Allison. It's not safe."
Cameron paused and studied Chase's face. What were his intentions? Did he think that she liked him? Did she like him? Could you truly like more than one person at a time? She still cared deeply for House - even that day could not change that. But what if –
She sighed, too tired to allow her mind to wander so carelessly. She focused on the situation at hand.
Eventually Cameron nodded slowly. "Okay."
Chase wrapped one arm around her side, grabbed his suitcase with the other, and led Cameron to his car. She rubbed her cheek against Chase's smooth jacket. She could feel the heat from his chest radiating onto her face. She could hear the familiar sound of a racing heart.
House did not move from his seat behind the desk. An emotion he had never experienced before tightened his chest to the point at which he could barely breathe. Regret. The potential consequences of his actions had barely registered as he prepared Cameron's folder.
He smiled bitterly as he recalled the night in which he held her hand. As he felt her soft fingers against his own, he had actually been happy that he had decided to give her the case. He had been able to enjoy that one moment of closeness while knowing that the seeds for pushing her away were already planted.
House was sick.
And he might have destroyed his only chance of being cured.
Author's notes:
Oooooh, the angst. It burns! I honestly don't know what has gotten into me. Less heavy stuff ahead, I promise.
Thanks for the great reviews! Keep 'em coming.
Okay, next. For future reference I like using a base plot (like the one I'm writing now) and then branching off at different points to create new stories.
For example: If I write something like
"House shoved his finger up his nose."
I have two options. I could have Cameron be grossed out or I could have Cameron find it adorable. I like to write stories based on either option.
Thus after this decision I'll have two different stories: One in which Cameron leaves the room because House was so disgusting and another one in which Cameron falls madly in love with House and his nose-picking ways.
With that said, I'll probably branch off from a decision made in the next chapter. So keep an eye out for the other version.