Disclaimer: 'House' is not mine, I just love to borrow without permission.
Trouble on the Horizon
House supposed he was lucky to have such a firm grasp on his sense of superiority. After all, ignorance and stupidity were catching, and if he were not careful, his IQ would take some severe battering, what with the recent standard of patients he was forced to assess. For instance, Elise Johnson- female, 18 years old. He studied her with resignation, noting the sulky curve of her lips which gave away her attitude of long-suffering disdain with the world, and wondered if the impenetrable fringe of artistically dishevelled hair that hid her eyes from sight was designed to protect her royal haughtiness from viewing the ordinary denizens of everyday life or to indicate her higher calling to a pursuit of the air of mystery. In any case, other than a deep progression into the self-absorbed condition of youth, she was most likely also suffering the typical teenage angst over various imagined and real physical imperfections. From what he could see of the rest of her face, the imperfections were blindingly obvious.
He broke the bad news to her. "You have pimples."
The insufferable fussy mother shifted uncomfortably in her seat. "I don't like to use that word," she chided him gently, brown eyes earnest. "It's insensitive, in my opinion."
House stared at her. "Oh, I'm sorry, I didn't know inflamed pustules had feelings. My mistake. If you feel you're more qualified to treat your daughter, by all means, I can just quietly withdraw and leave you to do the examination…" He made as though to move, but was not lucky enough to escape just yet.
"Of course not, you're the doctor, but my daughter is rather sensitive to criticism and that word doesn't help matters. There's so much pressure in her peer group about appearances, and having to look a certain way, it just causes a great deal of psychological damage when Elise can't fit in because she has the misfortune to look different."
The girl managed to look vulnerable and heroic at the same time, he noticed. "I see," House thought for a moment. "Does the term 'acne' sound better?" he asked, ignoring the gasp of disapproval. "Listen, Elaine-"
"Elise," she spoke up for the first time, swiping at the dark hair obscuring her eyes in order to glare at him. The martyr-like posturing had noticeably disappeared.
"Whatever. Do you know what causes pimples?"
She shrugged. "Something to do with excessive production of oil, at least, that's what our Health teacher told us. And sebaceous glands or whatever."
"She would be reasonably accurate, which is all you can really expect. I'm glad teachers are getting through to some kids, at least you seem to be paying attention in class. Eat healthy, drink lots of water and wash your face regularly. Basic simple stuff I'm sure your Health teacher mentioned, but maybe you didn't think she was qualified to advise you on that course of action." House looked at the mother, who looked undecided on whether or not he was being impertinent, then narrowed his eyes for good measure, just to give her something to ponder late at night.
"Can't you just give me some pills for it?" Elise asked bluntly.
House let out a howl of loud, uproarious laughter, clutching his stomach for effect, while the mother and daughter exchanged slightly unnerved expressions. "Pills, she says," he repeated to the mother in a genial tone. "Teenagers these days, always looking for pills to solve a problem. It's all about getting instant gratification, the quick fix to a predicament. Next thing you know Elise here will be asking for breast implants to fit into those skimpy bikinis all the better. Not that I have anything against people augmenting their appearance, just the natural envy that cosmetic surgeons make a hell of a living out of it. Did you know that 6.9 million cosmetic procedures were performed here in 2002? That's according to the American Society for Aesthetic Plastic Surgery, which calculated it was a 203 percent increase since the 90's. What do you think the statistics are going to be like today? Soon we're going to be living in a mechanized society with an identical, homogenous population. Is that really what you want to be part of?"
"Look, Doctor, I don't care about that, okay? Spare me the sermon. I've thought about surgery, to be honest, but mom won't let me til I have a part-time job and can afford to pay for it myself," she cast a disparaging glance at her mother before returning her candid gaze to House and resuming her brusque speech. "Right now, all I know is that all the other girls have this clear flawless skin, and no matter how many different products I try, all those cleansers and toners and 24 hour anti-spot blemish reducers or whatever, none of them work for me. So I just want pills from you. Anything that'll help clear up my skin. Do you think you can prescribe me something?"
"Well, since you asked so nicely," he said pointedly, "I suppose so."
"Thank you," Elise returned, sounding anything but grateful, more like she had more important things to do with her time and would appreciate him wasting less of it.
House was fairly thick-skinned, however, and was unperturbed. "I suppose you may as well join this generation's pill-popping, teen addict demographic." He pulled out his ever-present Vicodin and swallowed a couple. "Who knows, you might be lucky enough to get to my age and retain your pill-popping habit. That's provided the surgery goes well, of course. It's funny how you never hear about the severe disfigurement and even the occasional fatalities related to cosmetic surgery." He snickered as he bent to write out a script for the girl, continuing, "You think you're struggling to hold your head up now among your peers with a few spots on your face, imagine how hard it would be when you have cavities in your nose or you're paralysed into a permanent helpless, drooling grimace? Can't imagine your popularity would soar with that image." He ripped off the sheet and handed it to the mother. "There you go. Doxycycline Monohydrate tablets."
"What exactly does Doxycycline do to the system?" Mrs Johnson asked.
"It's an antibiotic from the class of medicines known as tetracyclines, which work by killing or stopping the growth of bacteria that make acne worse," he reeled off, turning his attention back to the girl. "It won't scar you for life, Elise, but you will have to rethink some lifestyle habits. Cut down on the junk- McDonald's will probably miss your fervent patronage, but they wreak havoc with your figure along with your skin. Isn't minding your weight also a focus of peer pressure? And I'd definitely advise against those Krispy Kreme's. In fact, just stick to nibbling lettuce and carrots here and there, you can't go wrong with the rabbit food diet."
Elise, ignoring him rather successfully to this point, had taken the script and was frowning as she read it. "Doxycycline…50mg?" she looked up at House with accusation. "That's not a lot, is it? I mean, I have a friend taking antibiotics, and they're like, a million mg or something."
"If that's the strength of the medication your friend requires, you might find it wise to make a new one- it's doubtful she'll survive much longer," House said wryly. "And if you want an increase in dosage, you do realize there will be side-effects?"
"Side effects?" Mrs Johnson repeated with concern.
"Mom…" Elise hissed warningly. "I don't care…"
"I appreciate that, honey, but I would like my one and only daughter to remain with me a good many years yet," she ignored her daughter's pained expression and continued, "What sort of side effects are we talking about?"
"Sunlight induced dermatitis, skin rashes or tooth or nail discoloration," House said carelessly, "Nausea, vomiting, diarrhoea, abdominal pain- and how highly do you treasure your liver, by the way?"
"Why? Can a person live without their liver?" Elise retorted.
"Let's just say I want to know what to tell the surgeons to do in case of emergency. I'm positive that the donor list would be more than happy to receive your organs. A heart transplant patient wouldn't look twice at your pimples if it meant you gave them the gift of life. Just think, you could accomplish all that and not even suffer stretch marks."
Realizing that House was mocking them, Mrs Johnson got to her feet with wounded dignity. "You can be sure I'll speak to your boss about this."
"Feel free, in fact, I encourage you to do so," House said. "We have a long-standing arrangement that for every quota of patients I offend, she gets to punish me. I have been a rather bad boy lately. Ooh, maybe she'll bring out the rhinestone studded whip again. Cuddy's very exotic in her tastes, you know."
The expression on Mrs Johnson's face wavered between well-bred distaste and reluctant curiosity. Elise shook back her hair, enough to peer at House with one inquisitive eye. The other was no doubt still caught in a vicious cycle of self-review and tedious assessment of her deficiencies.
"You won't be seeing me again," Mrs Johnson settled for distaste, her tone defiant.
"I hope not," House said with feeling. "Do you expect me to care? Not after the effort I went to for the precise purpose of alienating you. Give your daughter the pills, and go bother her teachers instead. Make sure to ask about her sudden attachment to one of the boys in the class, probably a loud-mouthed smart ass with a tendency to disrupt lessons."
"What are you talking about?" the mother asked, perturbed.
"Mom, come on, let's go," Elise dragged her in the direction of the exit. "He's obviously insane, let's not waste our time."
"I want to know what he meant by that!" she insisted.
"Your daughter would have been suffering from pimples for some time now, and yet she suddenly decides all of a sudden to do something to help her image? Any group of self-respecting mean girls hell-bent on homogeneity would have ostracised her from their ranks a long time ago. Obviously she's trying to alter herself now to appeal to a boy. It's well known that misguided kids like to enter relationships presenting themselves in the most idealistic aspect possible. One of the reasons why they never last, it's all based on a lie. Trust me, Elsie-"
"Would you just stop talking?" she demanded. "And it's Elise, you jerk!"
"If he doesn't appreciate you the way you are now, he'll never respect you. Dump his ass and find yourself a nerdy chess-playing sci-fi geek. Someone who would actually revere the ground you walk on. True you'd have to put up with endless recitations of passages from 'Hitchiker's Guide to the Galaxy' and lectures on the subtle distinctions between the various cash cows from the Star Trek franchise, but it's a small price to pay."
Elise finally succeeded in pulling her mother out of the room, and the door slammed behind them with a definite huff. House relaxed, a smirk creeping across his face. He had upped the ante on his measures for driving off patients; it was a technicality that appealed to him- he may have promised Cuddy the clinic hours, but she never said anything about his attitude in fulfilling them. If he successfully bullied and insulted his way through the waiting list, he would have just as much free time as before, along with her promise to endure his presence out of official hours. Before, he had reluctantly tolerated patients, and ignored them as much as possible. House was a naturally abrasive person, but that was nothing compared to what he was capable of when his full concentration was poised on that singular task. By devoting his attention to alienating them, he could more quickly press the issue of her promise. With all the excitement of this delicious new twist to their game, he could just wriggle with glee.
He took his own sweet time before venturing out to the desk to ensnare the next hapless victim. Catching sight of Cuddy conveniently nearby, House nodded his head in a calculatedly pleasant manner, and made sure to adjust the collar of the lab coat all doctors were supposed to wear- a rule which he had made a practice to ignore, until now, when he drew attention to his unexpected conformity. At her flicker of confusion and suspicion, House felt a sense of triumph- round one to him. He masked it an expression of pompous self-importance and collected the next patient without protest, feeling her eyes burning into his head as he innocently limped off.
A/N: I decided it was about time House did some clinic duty in this story of mine. I'm not a doctor, so I didn't want to handle actual diagnoses of mysterious illnesses!