In a Hallmark world, where politicians are judged on their ability to emote on camera and there's a bumpersticker for every sentiment, the person who doesn't wear his heart on his sleeve is automatically suspect. Failure to smile, weep, or hug according to universally recognized cues is widely considered a character flaw. People like House rarely challenge this view because they prefer not to disclose the truth: it's not that they can't feel strong emotions, it's that they would rather not.
It's a commonplace to attribute emotional repression to cultural norms as they applied to raising boys born before the 1970s. In fact, the world is full of middle-aged and elderly men who laugh and cry with equal abandon. But those who don't are often so hamstrung by their own self-control that they are the invisible walking wounded. The only thing more damaging than the internal turbulence this causes is the fear of ever letting it escape, especially after four or five decades of fermentation.
House encouraged his colleagues to think he avoided patients and their messy situations because he didn't give a damn because he'd rather be thought of as heartless than fearful. It was essential that no one guess that at the heart of his elusiveness was a horror of sympathizing. Sympathy could lead to empathy, empathy could lead to grief, and grief was unacceptable; it clouded the mind, sucked up energy, slowed responses. Above all, grief was an admission of failure; it meant you have accepted the intolerable.
Confronting Wilson's diagnosis brought everything to the surface for him. Not only did he sympathize with his friend over the battle ahead, he understood exactly how it felt to look into a future in which he could not practice medicine--and exactly how insupportable that thought was to someone whose entire existence had revolved around being a doctor since childhood, whose identity and self worth were inextricably bound to his profession. It revived memories and feelings he had struggled to bury for six years. It meant revisiting the months after the infarction, which was like returning to the dark alley where you were mugged and left for dead in a gutter.
-0-
He rose slowly through unconsciousness, a dark fog that at first only admitted the sounds of the ICU monitors and soft voices. The fog lifted, and he made out the blurred outline of Stacy's face as she bent over him. He smiled weakly. Her voice came muffled through the thrumming in his ears: "How do you feel?"
It took a minute to think that over. How did he feel? The fog lifted a little more, and he felt—pain. His leg hurt like hell. His heart sank, and the smile left his face. It hadn't worked after all.
"Still hurts," he whispered.
"You've had surgery," Stacy whispered back. That didn't sound right, so he chose to disregard it. "I'll get the nurse," she said. Yes. Moments later there was a pastel blur at his bedside; a syringe; blessed relief as the fog swallowed him up again.
The agony returned along with full consciousness the next day.
"What have you done to me?" he bellowed, as Cuddy blanched and Stacy wept. "Why didn't you do what I told you to do? You've crippled me, goddamn you!" He lunged at them, roaring, unmindful of the searing pain in his leg. A pair of husky male nurses appeared; restraints; another syringe; more fog.
Months later, still unable to walk any distance but somehow capable of acquiring alcohol and pills, he slumped in a chair glaring at Stacy and reciting a now-familiar litany: "You cut off my balls. Why didn't you just kill me then and there? Why do you hang around here now? I'm finished. Why don't you go find someone else to fuck over?" This time, instead of weeping, Stacy remained eerily calm. "This is bad for both of us. I'm leaving."
A week after that he was in the same chair, feeling numbness claim him as his vision dimmed. There was a distant thumping noise, accompanied by a different voice: "House? I know you're in there. House. Answer the door!"
But the voice was faint and easily ignored. His head lolling, he looked at the prescription bottle in his hand and noted with dull interest that it was nearly empty. He'd started out with one pill for the pain in his mutilated leg, liked how it also soothed the turmoil in his head, and took another. The third pill made him feel as if he were standing on the deck of a ship that was pulling away from the dock and all the thoughts and feelings he wanted to leave behind. He took a fourth pill to keep the ship sailing forward. How many had he taken since then, washed down by how much scotch? Did it matter?
There were new sounds now; two voices, a key turning in a lock. He tilted his head and saw a shadowy figure coming toward him. His eyelid was pried open; the bottle taken from his hand; the voice, addressed to some third party: "Thanks, I'll take it from here. No, I can deal with him, I'm a doctor. Thanks."
The shadow disappeared. He heard pots and pans clattering in the kitchen. A new bottle was forced on him: syrup of ipecac. A wave of nausea snapped him up and over, made him lean his elbows on his knees, and he vomited into a lobster pot until tears streamed from his eyes. The wave had barely subsided when the bottle was forced on him again. Through the retching and gagging, he heard the voice—now identifiable as Wilson's—murmuring "I know it's bad, I don't blame you, but it's fixable, you'll get through it, it's not worth dying over."
There's been a mistake, House thought. This isn't suicide, just a vacation cruise. He struggled to find the right words: "I don't want to die."
"I'm not going to let you," said Wilson, and House realized he'd been misunderstood. "No," he began, but succumbed to another wave of sickness before he could explain.
"Yes," said Wilson firmly. "You're going to live, and we're going to figure out a way to make it worthwhile."
Wilson stayed all day. He called home once to tell his wife they were having such a good time, he wanted to stay for dinner, then called her again to say he'd had too much fun and needed to sleep it off on House's couch. He probably didn't sleep at all, and it was House who stretched out on the sofa, obediently drinking whatever Wilson could find to rehydrate him with and dozing the rest of the time. The next morning he joined Wilson at the kitchen table and listened apathetically to a well-thought-out plan for putting his life back in order. That afternoon they met with Cuddy about putting him on staff. Cuddy, bless her soft heart and softer head, mistook House's listlessness as the sign of a sadder and wiser man, and agreed.
The months that followed were far from transformative. House continued to drink too much, pill too much, and talk too little; more than once, Wilson had to drive him home from some rundown bar or cover for him when he overimbibed at work. The rewards for this loyalty were few and far between; more often than not, Wilson found himself on the receiving end of a torrent of drunken abuse. But he never waivered in his support, never gave up on House, even when House tried to give up on himself.
-0-
Now Wilson was facing the worst crisis of his life, and House had paid him back by hooking up with a woman and becoming so enthralled with his newfound happiness that he ignored the disaster taking place right under his nose.
His feeling of guilt was amply supplemented with fear, and the memory of fear. Disability wasn't a "challenge," as the cheerleading pamphlets and counselors insisted; it was a daily reminder of the way anyone's world could be turned upside down from one minute to the next. You could live a carefully measured life, always wash your hands after peeing, exercise and diet and never smoke or drink, but no one was immune to the car that runs a red light, the germ of a neoplasm that sets the lethal cancer in motion, the dopamine cells that decide, for whatever reason, to stop working. The infarction had been the warning bell that told him a medical degree was not a hedge against disease, and much of what motivated his intense need to solve puzzles was the desire to know everything about every possible ailment so the next time fate tried to dope-slap him, he would be prepared.
-0-
House hadn't told Carolyn he wanted to get up early the next day, so she let him sleep as usual, and when he woke up it was almost nine. He rolled out of bed with a shout and dressed in a frenzy of creative cursing.
Carolyn was unapologetic. "You didn't tell me you needed to get up early."
Knowing he was being unfair only increased House's fury. "I've got a miserable day ahead of me, and I needed to be on time for once. No, no, I'll get coffee when I get there."
"Will you be here for dinner tonight?"
"No. I don't know. Aw, Christ, the traffic is gonna be brutal; it'll make me even later." He flung himself out the door, slamming it behind him.
The differential diagnosis only made things worse.
"Hallervorden Spatz," suggested Cameron.
"He's too old."
"Benign essential tumor?" guessed Chase.
"He's too young," said House. "Although I wouldn't rule out a garden-variety tumor."
"Progressive supernuclear palsy," said Foreman.
"No eye involvement. And you said he was responding to L-dopa."
Foreman nodded as if privately confirming something.
"Striato-Nigral Degeneration," ventured Cameron. "Shy Drager Syndrome."
"Now you're just taking stabs in the dark," complained House. "Come on, people, think outside the box."
"Maybe it's vascular parkinsonism," said Foreman.
"Now you're talking," said House, and he wrote that down on the whiteboard.
"Could be environmental," offered Chase. "Manganese, carbon monoxide, carbon disulfide, and cyanide are all implicated in secondary parkinsonism."
"Which is why you're going to check his apartment," House said.
"You want him to look for a manganese mine in Wilson's basement?" asked Cameron.
"I liked you better when you were humorless," House told her. "Yes, if there's a mine down there I want to know it; but he can also look for a malfunctioning furnace and pesticide use. Okay, what else? What's the single most common cause of secondary parkinsonism?"
"Drugs," said Cameron, "but I don't think Wilson is on antipsychotics or MPTP."
"Look anyway," House told Chase. "The rest of us'll start testing." He added "Wilson disease," "encephalitis," and "meningitis" to the list on the whiteboard.
"Encephalitis? Meningitis? Now who's taking stabs in the dark?" asked Foreman.
"I don't want to overlook anything," House said virtuously.
"You're gonna do an LP when he doesn't have any symptoms?"
"It won't kill him. Unless I do it."
"What about a PET scan?"
"Let's hold off on that for now."
Foreman nodded significantly, and left the room.
Alone in his office, House called the farmhouse.
"Don't hang up," he said, when Carolyn answered. "I'm a jerk, but I'm a repentent jerk."
"You were pretty upset this morning," she said evenly.
"This case is chewing my ass pretty bad. " He paused. "In fact, it would be better if I didn't inflict myself on you tonight."
Silence while Carolyn processed this and considered a psychologically sound response.
"All right," she said finally. "When will I see you again?"
"Tomorrow? Dinner?"
"Tomorrow is fine." But she sounded disappointed. "Should we meet somewhere?"
"Come to my office. That way you can drag me away from here instead of sitting at the bar at Micawbers for an hour."
She laughed a little. "Okay. I'll come by around 6. See you then. Miss you."
He hesitated only a moment this time. "I miss you, too." But she had already hung up.
-0-
By late afternoon Chase had returned empty-handed from his search of Wilson's apartment, and some of the test results were in. "Toxins," encephalitis," "meningitis," "tumors," and "vascular" had been crossed off the whiteboard list. They were waiting for a 24-hour urinary copper excretion test for Wilson disease, but the physical exam had already failed to turn up the golden or greenish-brown tinting, called Kayser-Fleischer rings, that are usually found around the corneas of the eyes of Wilson patients.
Foreman came in to pick up his things before going home. He stood looking at the whiteboard over House's shoulder.
"You're running out of zebras," he observed.
His boss threw him a hostile look. Foreman sighed.
"House. Everything on that board put together accounts for less than ten percent of Parkinson cases. You might have to accept defeat on this one."
He waited for a response; receiving none, Foreman left.
-0-
The first real heat wave of the summer had struck while they were in the air-conditioned environment of the hospital. Because he hadn't been there much for three weeks, House hadn't arranged to have his air conditioner installed, and his apartment was sweltering. It was also bare of sustenance—there was nothing in the refrigerator except a lonely beer and a dried-up piece of cheddar cheese, nothing in the cupboards except a box of stale crackers and a tin of sardines he didn't remember buying and that probably were there when he moved in. Lacking the energy to go shopping, House ordered a pizza. In spite of the heat, it was almost cool when it arrived. He ate standing up in front of the sink, washing it down with beer and chasing the beer with whiskey.
At the farmhouse, Carolyn would be chopping vegetables and dancing a little to the music on her iPod, which she had rigged to play through a boombox on top of the refrigerator. Angie would be setting the table and talking a mile a minute. If Nate were there he'd be getting in Carolyn's way trying to be helpful. Somehow, a finished meal would emerge from the chaos, a meal that made limp pizza all the more unappealing by contrast.
The evening dragged on. House tried to play the piano, lost interest, picked up a guitar, put it down. He assembled a collection of medical journals and flagged articles on movement disorders, but when he tried to read one, he found himself scanning the same paragraph over and over without comprehending it. At 11 o'clock he gave up and went to bed.
Bed was even worse. He'd opened the windows, but they admitted no breeze; just the sounds of the neighborhood, including mufflerless cars and an argument next door. His mattress was harder than he remembered, his pillows lumpier. He spread his arms and legs, taking up as much space as he could. The old Police song began running through his mind: "Bed's too big without you/Cold wind blows right through that open door; I can't sleep with the memories, dreaming dreams of what used to be…"
At the farmhouse, in the country, with the shade from the trees, it would be at least ten degrees cooler. Carolyn would have opened all of her windows, too, and with the breeze would come a rural nocturne: an owl at the barn, the occasional raccoon looking for an unguarded trash can, the frogs from a nearby pond. He'd be confined to half the bed, but the other half would be occupied by someone he loved, who loved him.
Had all that really happened? His memories of the past month were already taking on the gauzy quality of dreams. And the critical voice and the analytical voice were moving in to deconstruct what was left.
You didn't really think that could last, said the critical one, sourly. This isn't about Wilson, added the other. If nothing changes, nothing changes; and you won't change, not for anyone. She'll move on, find someone else. You belong to us.
House pulled the pillow over his head and willed himself to sleep. In his dreams he stood beside Carolyn at the barn, listening to her lecture on a horsey topic that was way over his head, but he didn't mind: he was watching her strong, clever fingers as she buckled the bridle and lengthened a stirrup leather. She smiled at him and said, apropos of nothing, "It was real, you know."
"I know," he answered, and felt such an overwhelming sadness that he almost wept.
-0-
The next day brought the final test results. Wilson disease was crossed off the list.
In a crisis, believers pray. Atheists make deals with the universe, whether they know it or not. Consciously, House told himself he was the same as he had ever been, without the time or temperment to sustain a healthy relationship with a woman. Subconsciously, he was bargaining with disease: I will give up happiness if you let go of my friend.
So when Carolyn stopped by to pick him up for dinner, he wasted no time in getting to the point.
"I think we should cool it for awhile," he said, staring at her feet. As an exit line it had the virtue of brevity, but as an explanation it seemed insufficient. He added, testily, "This business of 'It is what it is—'"
"Stop."
He looked up. Carolyn was holding up her hands in a gesture that was half command, half surrender.
"I get the idea," she said quietly. "You don't have to move in for the kill."
She turned and left without a backward glance. House stood for a moment, staring at a point on the ceiling. Then he went to his stash and took out two pills and swallowed them; shook out a third, broke it in half, and took one of those, too. He logged onto his computer and began searching medical databases. He had all night, now.
