A/N: Sorry for no update yesterday, kids. Also, my heartfelt thanx to Bax, who—when able to stay focused—(I hear Ritalin helps with that!), has some simply amazing insights into the mind of James Wilson, M.D.

CHAPTER EIGHT: Realization

Dick hasn't said much, just asked a few questions that sounded reasonably perceptive to Wilson. Now Wilson stops talking and waits for Dickinson's take on the situation.

"Would he be willing to come in and see me?" When Wilson explodes into a laugh, Dickinson says dryly, "I'll take that as a 'hell, no!'" Wilson, still laughing at the notion of House voluntarily entering a shrink's office, nods in confirmation.

Wilson smirks. "I'll spare you the eminent Dr. Gregory's House's opinion of psychology as a profession, but it's right up there with his opinion of snake-oil salesmen!"

Dickinson doesn't look too surprised. "Then this is what I'd suggest. Based on what you've told me, no one else is gonna be able to help him," Dickinson holds up his hand as Wilson, shocked, prepares to interrupt. "No one else will be able to help him because he won't allow it. It isn't a myth; there are a few people out there who can't be helped by conventional therapy. But that doesn't mean that they—that he—can't be helped at all. Dr. House is luckier than most; he's got someone willing to take the time, do the work. That would be you." Dickinson smiles at Wilson in admiration.

"And the unusual thing about this situation, James, is that you are uniquely qualified. Even when someone in Dr. House's predicament is fortunate enough to have a friend or family member willing to participate fully, the background and education usually aren't enough. In your case, that clearly isn't a problem. And you have the added benefit of being able to see to his physical issues as well."

"But Dick, that's part of the problem—a huge part! I told you what happened this morning; he could've died, simply because he couldn't bring himself to trust me. So now I'm gonna be his surrogate shrink? That oughtta tear it for sure." Strong doubt is apparent in Wilson's voice.

"James, you know better than that. It isn't you he doesn't trust; it's himself. You pointed out to me that he's still stuck in the denial stage of grief over the infarction. Add in his natural tendency towards depression—which I suspect was present even before the infarct—and you've got a man who can't allow himself to admit that he needs help. Because once he acknowledges it to himself, he's also gotta admit to his limitations. And he may never be ready to do that. As a matter of fact, from the way you've described him to me, it may be healthier for him in the long run not to ever acknowledge those limitations. "

Wilson is beginning to understand fully for the first time, and he feels a rush of compassion for House. He also feels a lifting of some of his own guilt; House can't accept help; nothing that Wilson's already tried to do could have been done any better—the results would have been the same. Wilson understands now that House's behavior is not controlled by House; it's an unconscious denial of his own circumstances.

"And don't forget what we all learned in Psych 101," the psychologist continues. "Tragedy tends to bring out both the best and the worst characteristics in people. When the tragedy becomes chronic, those characteristics are magnified over time. So if he's always been loathe to rely on others, now it becomes an overriding force in his life, in his attitude towards both his illness and towards the people who want to help him. He's literally programmed to fight you."

The newfound feeling of compassion towards House threatens, momentarily, to overwhelm Wilson. "So he's not responsible for his behavior?" he asks.

"Afraid not." Dickinson's mouth twists in a rueful, sympathetic smile. "No more responsible than your average preschooler who's heard the word 'no' two too many times."

So Cuddy's spot-on in her assessment of House's personality. And that 'Nanny 911' thing isn't too far from the truth. Viewing that big jerk as a child will make it easier to be patient, though, not to just give in and kill him. Wait'll I tell Cuddy she's had the right idea all along; she enjoys being right almost as much as House does!

"Is there anyone else he's close to? Someone who can share this... burden... with you? It's gonna get pretty rough... "

Wilson knows the answer, but he gives the question long thought before replying. "Lisa Cuddy, our boss, Dean of Med at PPTH. She's with him right now. They have a... complex... relationship. But I think it's been changing, in a positive way, over the last few days. I think he's starting to trust her, at least as much as he can trust anyone. His parents, but they're distant. Both geographically and emotionally." He silently curses House's father, John, for his part in House's inbred perfectionism and the attendant depression. "Stacy, of course. He still loves her, but he also blames her for everything that's happened in the last six years. And she's distant, too." Wilson admits, sadly, that the only people House can really count on are himself and Cuddy.

"So, you're not doing this single-handedly. Dr. Cuddy will support you?"

Wilson doesn't hesitate. "She will--every step of the way."

"Since there's just the two of you, and since I think the bulk of the burden will fall on you, despite Dr. Cuddy's support, I'd like to suggest that you get yourself a punching bag." At Wilson's small laugh, Dickinson says, "I'm not joking, James. You don't understand how rough this is gonna get, having to watch—having to allow—an adult to essentially react to his life like a peeved four-year-old would. You'll need an outlet; I mean it."

"I can handle this, Dick. It's... a relief to know that he's not just the selfish bastard the rest of the world sees. I know that the man I've described to you sounds... sad, and sick, not someone anyone would want to know, but there's so much more to him. He's brilliant, and funny, and... I dunno, it's just an honor to be allowed into his world. Can't explain it; you'd have to meet him, and look past the walls he puts up. Maybe then you'd understand why he's really worth it. When he allowed me to put him through the pain control procedure, even after what's gone on, it was... it made me feel good, like I was somehow worthy of his friendship."

"That's another thing we need to talk about, James—the loss of that extra pain. It's going to be part of the problem, believe it or not. You've said that he's integrated this pain into his personality, his behavior. That means that a big part of his perception of himself disappeared when the pain left. And whenever your self-view changes, there's a period of grieving attached, even if the event itself is a positive one. He's going to find it disconcerting, at the least, and deeply disturbing at the worst, to have such a big part of his identity gone. And that'll result in more anger, more lashing out, while he tries to come to terms with this shift in self-perception. It shouldn't last more than a month, but it could be a very nasty month."

Wilson hadn't considered that getting rid of the breakthrough pain cycles could have any sort of a negative impact at all. "How can I help him through that?"

"I think you're already doing that for him by instinct. Just be there for him. Let him lash out at you; that'll be his way of working through his own confusion. The 'attacks' on you aren't really attacks; I think what he's doing is analyzing the changes in his life in a way that has, historically, made him feel safest. He sees you as a secure sounding board, and that's what he needs most right now."

Wilson takes a deep, deep breath. "Dick, I've been here almost two hours now. You haven't called out the little white-coated men with the nets yet—for House or for me. So I'm thinking maybe I should mention one more… mmm… concern."

Dickinson waits patiently; just like House, he knows that the biggest concern tends to manifest itself at the end of the appointment.

Okay, sorry House, gotta do this, buddy—not gonna lose you now. "I think that House may have a suicide plan." Wilson looks directly at Dick, and the psychologist sees the fear, and the desperate plea for reassurance, in his eyes.

"That doesn't surprise me in the least," Dickinson says, and sees the surprise on Wilson's face. "In my experience, at least half of all chronic pain sufferers have a plan. And that plan is, often, what actually prevents them from becoming acutely suicidal. Just knowing that he has his 'out' gives him the comfort he needs to get through the rough spots. He's really at less risk of suicide than someone who's less organized, more impulsive."

Wilson finally allows himself a relieved sigh that starts somewhere deep inside his soul. "I was so worried…."

"Understandable. And I'm not saying don't watch for signs; I'm just saying that, at this point, it's likely that he's no more at risk for suicide than you are. More of a problem, I think, is keeping tabs on his physical condition; sounds like that's putting his life far more at risk . You're the physician here, but I'd suggest simply explaining to him that you know it's hard for him to speak up when something's bothering him. Tell him that you're going to be monitoring him closely for your own peace of mind. Take the pressure off him—that often has an interesting result; he may become more willing to be truthful with you."

"That would be interesting." Wilson smiles. "I think I've taken up more than enough of your time, Dick. And I'm anxious to get back, find out if House and Cuddy have killed each other yet. Let me ask you something; you still play a mean game of poker?"

Dickinson grins. "Oh, yeah. Can still make you wish you'd left your wallet at home. Why?"

"Well, how's this? We give House a few weeks to recover, let me slip your name into a few conversations with him. And then, you're invited to a poker game you'll never forget." Wilson grins too, wonders what nickname House'll christen Dick with.

"Sounds good, James; looking forward to meeting Dr. House. And it was great to see you again." He hands Wilson his card. "I've written my home number on there; call me anytime. Questions, problems, or if you just need to vent, okay?"

"Will do; thanks again." Wilson is headed towards the door when Dickinson calls out to him.

"James, one more question--what are you getting out of this?"

"Well, I hope that House'll be able to ac--"

"No, that's not what I asked. I know what benefits we're hoping he'll get. What I want to know is, what's in this for you?"

Wilson blinks as realization dawns. "This time, I don't lose my brother," he says quietly. And he thinks, This time, the demons don't win.