Wilson had to see if it was true. What sort of bat shit crazy individual would actually use valuable time off in order to torment a junior attending? Time that would normally take him away from a place that causes utter discontent. Even House couldn't be that crazy.
Yep, he is. Wilson's disappointment was realized when indeed he saw House there, completely relaxing in his office watching TV. This was no different than any other day at work by the looks of it.
"I was going to call, see how your flight went. Somehow your brilliant mind has come up with a way for you to be two places at once." Wilson said in his usual lecturing tone.
"The weather here is great. I was going to have one of those umbrella drinks in your honor. Then I thought, no, this vacation should be about me." House replied in retaliation.
"Apparently. Remember when we had that discussion a way back about you needing to find a better outlet? You have got to learn to be better at something else. Now your behavior can be considered pathological. Since you are in Cancun, I would recommend cliff-diving. There is a thrill seeker with potential for catastrophe, which isn't much different from what you are doing now."
"I actually took a vacation, didn't I? You have to admit that is a breakthrough."
"Using your personal time to cause tremendous grief for someone who has so far proven to be a worthwhile employee is not something they like to bring up in management sensitivity training," observed Wilson.
"You're just jealous that you have to stay behind and work. Come on, admit it, you want to go too."
"No, I'm going to do something better. I'm going to do something that will so drive you nuts and all you can do is sit there and watch. I'm going to give encouragement, support, and advice to your new attending on his first case since you aren't here to do so."
"You wouldn't." House said as he popped up taking the threat seriously. "What the hell am I saying, of course you would. Does your outfit come complete with tights and a cape? Superhero nice doctor swoops in and saves the day. Stay away. I don't meddle with your staff."
"Actually, you do all the time," countered Wilson.
"You and I never agree when it comes to the children. They need tough love. The boy has to learn these things himself."
"Pardon me, I didn't hear that. You aren't here."
"You're spoiling them. No wonder they like you best." said House as Wilson walked away.
Wilson left the office smiling because for once he was leaving with the upper hand. He had to savor this moment intensely.
-------------------------------------------
Chase was busy in the conference room processing all the records that he received for Estelle. Only a few doctors still owed him records, but he knew enough to really get started. He had trouble understanding how all these doctors would just look at the one particular problem and not look at the entire picture. To just write a prescription for one ailment was a mentality that was so lost on him as a fellow doctor. Sure, he was guilty at times of just writing a prescription without knowing all the facts, all doctors were. How could Estelle get so many doctors though to act like that? Given the state of her apartment, she likely didn't have any friends or anyone who was willing to check on her. She probably annoyed anyone who came in contact with her, which meant her doctors wanted her out quickly. That was no excuse, but a very likely scenario. He had seen it way too often.
While lost in that train of thought, Chase received a page. He looked at the message and raced up to the ICU.
Chase arrived a few minutes later to find Cameron standing in the background while the crash team worked on his patient. "What do we have?" Chase asked jumping into the middle of the action.
"Cardic arrest," said the trauma doctor on duty. They had already started using the paddles and had been working for several minutes. "Epinephrine now!" shouted the doctor.
Just as she uttered those words, Estelle's heart went back into normal sinus rhythm. "Hold off on the epi or anything else," ordered Chase. "She has hypothyroidism and hypertension. Who knows what any type of stimulant will do to her already fragile state. Let's see if she stabilizes on her own."
Chase walked over to Cameron to see what happened.
"Chase, we have to give her some type of stimulant," said Cameron. "Otherwise she will have another attack or even worse."
"If we do anything we might get the same result. She is a train wreck. We need to know more about what is going on." Chase then realized what he was doing. He knew it was never a good idea to disagree with a colleague in front of a patient, even if the patient was unconscious. He stopped himself there and led Cameron out into the hall.
"What happened?" Chase asked Cameron now that they had a bit more privacy.
"I just got a liver sample to perform the test. Next thing I know she was crashing."
"Did you get the sample?"
"Yes," replied Cameron.
"Go perform the test. If her liver isn't failing due to the drugs then we can administer something to stabilize her. Until we know all the facts, she gets nothing. Her system likely doesn't want us bothering it right now."
Cameron nodded and went to the lab to perform her test.
Chase stood in the hallway alone, staring through the glass while the nurses finished up with Estelle. He didn't know if he was doing the right thing, but he surely was convinced it wasn't wrong either. Still, House would be having a fit over such a cautious strategy. Too bad, he thought, at least the patient is still alive.
"There you are," said Foreman. "I have been looking all over for you. Is she stable?"
Chase nodded with a bit of a frazzled look on his face.
"The best I could get was an MRI tomorrow morning," said Foreman
"We need one now," said Chase. "Did you tell them that was unacceptable? Our patient is a time bomb here."
"They are backed up and didn't see her case as urgent as the others. They don't get very sympathetic to drug users when there are other priorities." replied Foreman.
"You left it at that? Especially since her drug use is legal?"
"No. I told them that my attending would be contacting them." He gave a smile and patted Chase on the back. "Good luck with that."
Chase couldn't believe what he was going through just to deliver basic medical care to a patient. No wonder House has resorted to treachery. It was the only way to get anything done.
-----------------------------------
Chase took the long walk upstairs to the MRI desk. He knew the person responsible for the scheduling well. His name was Brian, and he never did like him very much. He was such a weasel. Chase knew he had suck it up though and play nice.
"Brian, please, I need to get a patient in for an MRI stat," Chase said to this young man as he worked on paperwork behind the main service station.
"I have some time tomorrow morning."
"Dr. Foreman already scheduled her then. I need her in now. She just coded in the ICU and we can't figure out what is wrong with her."
"Oh, so you're the attending he was sending to give me hell?" Brian paused to laugh. "Geez, how anticlimatic. I was expecting Dr. House. I had a good argument planned."
"House is on vacation. My patient needs to get in now."
"No such chance. We are all full. Tomorrow is looking good."
"Come on, we are both reasonable people..." Chase said trying a smooth approach.
"Sorry, the kindness act doesn't work on me," he interrupted. "Tomorrow."
Chase paused for a moment and then got an idea. He hated using a House tactic, but he was desperate. "Brian, I know all about the smoking weed with the orderlies on break. Should I have a talk with your supervisor?"
The young man laughed harder this time. "You won't say anything. You aren't that devious. Even if you are, go ahead. I dare you to prove it."
"A patient is dying and you don't care?" said Chase who was trying desperately to find the right tactic to work.
"Look Dr. Chase, I have put up with all of House's tricks for way too long. It's about time his department took its proper place in line. Everyone is dying today. Take a number."
Chase had nothing else to use. "Your boss will be hearing from me." Brian looked less than intimidated. Chase gave up and went back to regroup.
-------------------
"She is in great strife and we don't know what is wrong with her." Chase said pleading to the person on the other end of the phone.
"She wasn't abusing prescription drugs, she was following her doctors orders…"
"Yes, I know no reasonable person would take prescriptions from that many doctors, but she isn't reasonable…"
"So just because she's a little mentally ill that doesn't give her the right to a quick MRI that might save her life?..."
"If she dies in the middle of the night you are the first person to testify at the review." Chase slammed down the phone.
"Great," said Foreman. "Pissing off the MRI supervisor is not going to earn you any future favors."
"It never hurt House," said Chase. "Then again, I'm not that evil."
"So, you are just going to give in and wait until tomorrow morning?" Foreman asked.
"It's already late in the day. She just needs to stay stable for an evening." Chase said resigned by the fact that he lost this battle.
Then Cameron appeared in the doorway. "I have the results. She has acute liver damage from the overload of drugs, but not enough yet to cause failure or other significant problems. You should see this though." She handed Chase the sheet of paper showing the results.
"Cancer?" he asked surprised by the result. There were none of the typical signs of liver cancer.
"Maybe. There are some abnormalities that make it possible. Dr. Wilson is around and waiting to hear from you for a consult."
"Great, maybe he knows secrets as to how to get an MRI too," replied a very cynical and tired Chase. "You two can go home. There is nothing more to do this evening." Then he turned to the office. "That goes for you too, House!"
Chase grabbed the file and dragged himself off to yet another area of the hospital to talk to yet another source about his troublesome patient. Cancun did sound rather appealing right now.
---------------------------------
"Dr. Chase I presume," said Wilson as Chase entered his office. "You are looking a bit haggard. Case not going well?"
"What House hasn't told you about every moment? I'm giving him enough material to taunt me for the next hundred cases."
"I refuse to talk to him while he is on vacation. He needs his quality "me" time." replied Wilson. "Do you think you are actually doing anything wrong?"
"No, I'll admit to being cautious, but this is no normal case."
"I have heard that. So what do you have for me?" Wilson asked easily wanting to get House out of the conversation.
Chase handed him the incredibly thick file that seemed daunting for a case that was only presented earlier today. Wilson opened it and Chase enjoyed watching his eyes jump out of his head just like his own had earlier in the day.
"You need more than a consult," Wilson said as he flipped through the pages. "You need some sort of divinity here. You could call her a miracle patient because she is still alive."
Chase smiled at the comment, probably the first time he has smiled all day. "Yeah, I'm sure I could convince the Catholic Church easily to declare this a miracle. It would be a slam dunk."
"Cameron's test definitely hints that something is there. If it is in her liver, she likely has similar problems in other organs. You have the MRI results?" asked Wilson.
"That is a bit of a sore subject right now," replied Chase as he got a quick look of aggravation. "I'll have something for you tomorrow morning."
"Chase, I know you aren't one to ask for advice, but do you mind taking some this one time? You know, from one attending to another." Wilson said sincerely.
"Sure," replied Chase.
"The respect will come from others, but it will take a lot of time. When it comes to your fellow doctors, House is the only one that respects you. He has very strange ways of showing it, but you wouldn't be in this position if he didn't. The point is, once people see you as something other than House's yes man, it will get easier."
"Did you have the same problem when you became an attending?"
"You don't want to hear about my ordeal," said Wilson with a big smile. "I'll scare you too much. I made mistakes, but it turned out that was okay."
"Thanks Dr. Wilson," said Chase with an appreciative smile.
"Just relax and go with your instinct. It really is that easy." Wilson replied. "And I need that MRI no later than tomorrow morning."
"Yes sir," Chase said as he left the office. He was ready to go home and crash now.
