Mayhap an act of God, but this chapter is complete. Remembering the brilliance that was the episode where House first appeared before the students I hope you accept this humble submission in a kindly light.

I doubt this chapter shall be updated for a period as I have another chapter to write for a Firefly fic, before embarking on the end of my seemingly eternal CSI work. However, if you would like me to continue this fic please let me know.

I had been trying to forget my CSI fic, but 'tasha, who beta's it for me (actually, she abuses me and calls it beta-ing) threatened to rip my lungs out and mount them on the side of my head if I didn't finish it; so I'm acceding to her polite request.

As always, thanks to those of you who read – and review-

All things dull and ugly, All creatures short and squat,
All things rude and nasty, The Lord God made the lot;
Each little snake that poisons, Each little wasp that stings,
He made their brutish venom, He made their horrid wings.
All things sick and cancerous, All evil great and small,
All things foul and dangerous, The Lord God made them all.
Each nasty little hornet, Each beastly little squid.
Who made the spikey urchin? Who made the sharks? He did.
All things scabbed and ulcerous, All pox both great and small.
Putrid, foul and gangrenous, The Lord God made them all.
-- Monty Python's Flying Circus

Cuddy looked worried. Against her better judgement, she'd decided to attend the lesson, despite knowing that she'd sleep much better not knowing what House was going to say. However, a combination of horrified fascination and protective mother-hen instincts, at least, that is, for the mental well-being of the students as she knew House could – and inevitably would - look after himself, had involuntarily led her here and, at this point in time, it was too late to either change her timetable or, for that matter, to move to a mode adequately protected bomb shelter to avoid the inevitable fallout. Of course, in situations where Gregory House was involved, the concept of inevitability had a tendency to gather momentum and intimations of impending doom - usually presented in the form of a large, razor-sharp Damocleatian sword with special hospital-administrator skin gift-wrapping – were omnipresent.

House, for his part appeared in front of the class in his usual dishevelled state, much like an unmade bed although an unmade bed tended to affect a slightly less disaffected manner and, for that matter, one somewhat less fatalistic. House, Cuddy was aware, believed that the Lord, in all his wisdom had put other people on the planet solely to test him and, thus, the man forever assumed the mien of Job when coming into contact with anything that walked, crawled, scuttled or slithered on the face of the earth. For that matter he wasn't known to be overly fond of creatures that flew or swam…and then there were students. Now, standing at the lectern, he reviewed the assembled morass of assembled educational optimism and his face assumed a slightly offended expression as if something he had just scraped of his shoe had come to life and was now waiting for him to do something entertaining.

"So," the laconic voice drawled from the front of the lecture theatre, "you wanted me back. Feeling inadequate were we? Or, did some form of collective death wish inspire this potentially suicidal enterprise? Perhaps," the mellifluous voice continued, "we may consider this as the lemmings' approach to medical education; because if necessary, and in consideration of your woefully inept performance from the last time I had the misfortune to cast my eyes on you, I am more that happy to chase you off a cliff; for while you may, and I stress may, hold some small measure of ability, what that precise ability is is yet to be fully determined insofar as the only talent any of you demonstrated previously was an inability to make decisions; or at least," he amended "decisions that you are actually prepared to defend. Decisions are not flotsam and jetsam, neither are they life-rings thrown to you by the hospital's litigation team; decisions, ladies and gentlemen, are your stock-in-trade. Here's a newsflash kids, the first thing you have to understand about being a doctor; that is," he amended, "a real doctor and not a pharmaceutical company's pill pusher, is that it is inevitably you will get it wrong and the patient will die; if you can't accept that, then give up now and become a stamp collector."

"But not every medical decision is about life and death Doctor House."

House regarded the questioner with a level expression, the type he usually reserved for hospital administrators, Chase, and Wilson when he attempted to act as House's conscience. "Possibly true if you have the spine of a jellyfish, but definitely, and inevitably, wrong. Just because some retard with a minor case of the common cold isn't writhing in front of you doesn't mean that there's something wrong with them. It also doesn't mean that there isn't. But in either case that won't stop them dying when they have a reaction to the medicine you prescribed."

"But if I don't know about any potential reactions how can it be my fault?"

"Because you prescribed the medication, end of story. Lesson number one: whether or not it is your fault if something bad happens you are responsible; accountability is everything and if you're not prepared to be accountable you had better make sure you have someone else to blame," he grinned maliciously at towards the back of the room where Cameron and Chase had positioned themselves; "this is why I have minions. You, however, being little better than noxious bacteria will have to make do with owning up to your own incompetence. Also, it is important to remember that if you're prepared to take the glory for something you didn't do then you also have to be prepared to assume responsibility for all the over things you didn't do. People – and hospital administrators," he added, casting a wry glance in Cuddy's direction "don't care about reasons, all they care about are results," or perhaps, he noted sardonically, "that should be liability."

Cuddy buried her face in her hands knowing that she should have trusted her instincts and asked anyone other than House to deliver that day's lecture; but no, having bowed to the request of the students she was now she thanking the higher powers that Vogler was otherwise engaged. As she looked about the room, on the off-chance that she might spy a kindred spirit with whom she could commiserate she noted Chase and Cameron seated side-by-side; reflexively, she smiled, for they resembled nothing so much as a pair of drama masks one amused, one horrified; it was, she thought, a very apropos way to consider the mystery that was Gregory House: the agony and the ecstasy.

"But you experiment with your patients all the time; isn't that inconsistent."

"Two things:" noted House. "Consistency is the mark of a small mind and, I've killed enough of my patients to know what I'm doing. Now, if you've nothing else we'll move on." Taking the silence as an invitation, House continued "The last time I was here the most important thing to note was your remarkable ability, as a group, to start with the blindly obvious and then ignore everything else to the contrary until it was too late to do anything other than sit back and admire the consequences; indeed, your collective belief that if it looks, barks and shits like a dog it is indeed a dog leads to more problems than it solves, and frankly, if we left a sick dog in your care we'd end up with a dead camel.

"That's not entirely true Doctor House."

"So tell me, oh lowly, apprentice minion, what is the truth?"

"You led us to believe…"

"…I led you to believe nothing. Each time I presented a piece of a scenario you all jumped on it like it was some sort of Holy Grail. Each time you were sure that It Was The Answer. Examined options you did not. Consequences acknowledged were not. Afraid of appearing ignorant you were. Fear leads to anger, anger leads to malpractice…"

"And malpractice is to be feared above everything else?"

"No. Malpractice leads to Doctor Cuddy and thence to the dark side. Alright, let me ask a question; what drives a doctor?"

"A need to heal. To make sick people well."

"If you tell me you believe the children are our future and that you want to make the world a better place I'm going to be sick."

"How about the requirement to pay their green fees?" came a voice from the back of the room.

House glared in the direction of the palpably Australian accent "Shut up Chase."

Returning his attention to the students, he continued. "The thing that drives a doctor is the requirement to meet expectation. See the thing is society has placed the idea of the doctor on somewhat of a pedestal, that is, if you're sick; go see a doctor, the doctor knows all. This way of thinking has reached a point where people go to the doctor not because they are really sick but because society tells them that is what they must do if they feel ill; where ill can be anything from death to a sprained ingrown hair. In turn, we have doctors, unable to find anything wrong with said patients, prescribing medicines in order to meet an expectation of being made well on the patient's part that is more psychologically than physically based; the result of this is, of course, an overuse of medicines and a concomitant increase in bacterial resistance."

"This is all very sociological Doctor House, but do you have a point?"

"That's like asking you if you have a brain; the only difference is that I'll get to my point." House sighed mightily; dealing with idiots was so tiring, "Now, if we extend the above scenario to its logical conclusion we note that patient expectation becomes one of medical infallibility and evidenced medical behaviour becomes one of Delphic inscrutability and omniscience; that is, if nothing's wrong the doctor will invent something and if there is something wrong and the doctor doesn't know what it is they will seize onto the first possible thing it might be – however unlikely - in order to make it appear to the patient, or their families, that they do indeed know what they're doing."

"But you have to do something, you can't just let patients sit there and rot."

"Well, the jury's still out on that one; personally, I think we could all do with less sick people, nasty messy things that they are, however, their families get upset if you let them die, and then they moan to Cuddy, then Cuddy gets upset and…" he caught sight of Lisa Cuddy's increasingly stony expression and decided to move on.

"Questions?"