With thanks to Benj and Soaranteagle, cutterdog, Astras 2003, sasmom, Noreen3, lauriefan, hughfangirl333, Master of Hugh, Auditrix, Armchair Elvis and all those who wrote in the Episode 2.13 Spoilers thread on Devoted to Hugh and Why Vicodin thread on House Fans. Without the input of their discussion I could not have written this chapter.
LEGACIES AND LOLLIPOPS TWELVE – FIRST DRAFT
They didn't let me see Greg until he was in the Intensive Care Unit. Both Cuddy and Wilson warned that Greg was hooked up to a myriad of tubes and machinery and said I should not be shocked by the way he looked. I nodded my acceptance and then turned to Cuddy.
"You'd better have this." I said handing her a sealed envelope. "It's my resignation. Open it if you consider it no longer possible for me to continue to represent PPTH in Legal Matters." Although I no longer held Greg's health proxy I would be free to be his advocate. And it was clear to me that if I was his advocate it was likely I would have to oppose Lisa Cuddy.
"Are you certain about this?" She asked but her relief was obvious. And I knew now that I could do what I had to do for Greg.
"Yes. Absolutely." I then entered ICU escorted by Wilson. I shivered at the first sight of Greg he was ashen. He scarcely resembled the man I knew. He seemed absent, looking more like a cadaver being kept artificially alive while waiting organ harvesting, than a survivor.
"Stacy's here." Said Wilson placing a hand on Greg's shoulder. "Stroke his cheek." Wilson told me and I did finding the small patch of skin free of the surgical tape that secured the tubes that entered his body through his nose and mouth.
Greg's eyes opened partially and for a moment they met mine but there was little recognition and then they closed again. I looked at Wilson I wanted more information.
"He'll be like this for the next day or so. He not in any pain, Stace. He is just very weak and it is going to take time."
"Can I kiss him?" I asked.
Wilson nodded I leant over the bed and kissed Greg on the cheek. "I want you better, Greg." I whispered to him. His face moved towards me and I noticed his eyes had opened again. This time there was recognition and this time a tear fell from his eye and rolled down his cheek where I had just kissed him. We looked at each other silently. Lovingly.
"Pathology was clear, House." said Wilson. Greg nodded seemingly taking in the information and slowly his eyes shut.
"Sleeping like a baby" said Wilson and guided me out of ICU as we walked down the corridor towards the elevator Wilson filled me in on the operation.
"It was a real mess. If it hadn't happened here, Stacy, he would've died." Wilson needed to talk about it, satisfying himself that everything had been done correctly. I reassured him that he had not failed his friend.
I had to get to my office. While I still had a job I had work to do. I remembered New Jersey was the only State, which regulated on the treatment of intractable pain. There was a copy of the legislation in my files I grabbed it realizing that while it mirrored the federal regulation on there were a few significant conditions which intending to delimit the treatment of intractable pain opened up a legal minefield to the medical practitioner. Opening the file I noticed that someone before me had been concerned with this issue. Concerned enough to clip a printout of a vital paragraph to the first page.
"When protracted prescribing of narcotic drugs is utilized for the alleviation of intractable pain, practitioners shall remain alert to the availability of new or alternative types of treatment. The practitioner should attempt periodically to either cease the medication or taper down the dosage, or try other medication or treatment modalities in a regular and vigilant effort to reduce the addiction propensity for the patient. (New Jersey Board of Medical Examiners, 1993, p. 64)"
The sentence had been underlined by hand and an angry note scrawled below. "There is a difference between dependence and addiction!
Check out OPIOPHOBIA.
And for God's sake read Jacob Sullum's article "No Relief in Sight" in Reason. He writes "Torture, despair, agony, and death are the symptoms of "opiophobia," a well-documented medical syndrome fed by fear, superstition, and the war on drugs. Doctors suffer the syndrome. Patients suffer the consequences."
There didn't need to be a signature I knew Greg's writing better than my own.
I went to the computer. There were about fifty emails from Mark, which I decided would have to wait. I opened up a search engine and typed in pain+management. I downloaded the Sullum paper read the reports of the Anesthesia Pain Service and other specialist pain management groups and then read through anguished letters and blogs from people suffering chronic pain. And then my eyes fell on a letter from an anonymous doctor about a colleague.
"Everyday he attends work is an act of personal courage. This is a man without reserves of energy or fortitude so there is absolutely nothing left of him at the end of the working day.
He measures himself and manages his output of energy and intake of medication with care. But if any unforeseen physical or emotional event comes along he is at risk. It is then clear just how fragile he has become as a result of his original injury and the continuing under treatment of the severe pain he has now suffered for many years. He compensates by keeping others at a distance that they don't, won't, or can't see it.
Some aspects of his personality indicate the chronic pain may have remodeled his nervous system. He may also be suffering from pseudo-addiction due to inadequately treated pain. He deserves more understanding but behaves in a way that leads some of his colleagues to believe he is addicted when all he requires is better pain control.
He is irritable, acerbic and often appears intolerant but I consider it a privilege to be working with this remarkable and brilliant doctor."
I hit print. I was certain the anonymous writer was Cameron and the subject had to be House. She and Foreman were seeking consults on pain-management once I had all the legal material together I decided I would share the information with her. I picked up the phone decided first to call Dr Steigler who had operated on Greg's spine less than twenty-four hours ago. I trusted him.
I got him on his cell. Hearing that breezy good-natured voice lifted my spirits. I didn't have to explain anything to him. "Stacy everyone on the eastern seaboard knows what is happening with House. You want to tell me what you have observed? We can meet."
"I can't leave here right now. I certainly can't take the time to get to New York." I said my mood plummeting.
Steigler laughed.
"Stacy, I am on my way to you. And I am bringing an old friend. See you in a couple of minutes. Chin up, okay." he hung up.
Two minutes later Steigler opened the door to my office.
"Surprise!" He said. By his side was a beautiful and stylish Chinese woman. "I think you already know the distinguished Professor Chan."
"Tink. My God, Tink" I had only spent that one evening in Singapore with Tink and her husband Julian who like Steigler was a microsurgeon. Even though we had not kept in touch, I had known then as I knew right then, I had met a friend for life.
"I am just printing out a paper of yours. I didn't know Professor Theresa Chan was you."
"Well I was just 'Tink' in Singapore. I was just here for a pain management conference in Washington and Julian and I decided to turn it into a holiday and spend some time with Joe Steigler and his family. We were going to try to get in touch with you and Greg."
"Fortuitous coincidence, Stacy. Dr Cameron called me the moment House was taken to the OR. She was trying to contact the Professor here. The convenors of the Washington conference gave her my number."
"Are you going to be able to treat Greg?" I looked at Tink hopefully.
"I can only observe and suggest." said Tink but obviously the line was blurred.
"Naturally Lisa Cuddy was delighted that one of the world authorities in pain-management consented to giving two lectures at PPTH." There was a real twinkle in Steigler's eye when he said that and I realized I was not going to have to go to war with Cuddy or anyone else to get Greg help.
Steigler turned to see Cameron.
"Dr Steigler. Professor Chan I'm Dr. Cameron. I am so glad you could come." They shook hands.
"As I told you Greg is an old friend. I wish I had known at the time of the infarction. The under-treatment dated back to then?"
"In my opinion. Yes." I knew then that she had written that letter. I hoped Greg appreciated her skill and perception more than he let on,
"It must have been a living hell for him," said Tink. "Can you take me to see the patient?"