Chapter 22
Cameron sat at the conference room table watching House write symptoms on the whiteboard. She really didn't know why she felt so strongly about this case; she just knew she needed to be part of it.
Foreman and Chase, responding to their pagers, entered the conference room and sat at the table.
"New case?" Chase asked.
"Your grasp of the obvious never ceases to amaze me, Dr. Chase," House snarked without turning. He finished writing and stood back slightly to look at the board.
10-Year-Old Female
Fever
Vomiting
Fatigue
Headache
Muscle weakness
Facial twitching
Seizure
"Okay, go," House turned to the ducklings.
"Meningitis" Chase suggested.
"Doesn't explain the muscle weakness and twitching," Foreman replied.
"Maybe its meningitis and something else," Chase said.
"Something else like?" House questioned.
"Bell's palsy," Chase replied.
"Good," House said and wrote meningitis and Bell's palsy on the board.
"Neither of those would explain the seizure," Foreman said.
"The seizure could have been febrile," Cameron remarked. "She's a little old, but her temperature was over 103 degrees."
"You can't just ignore a symptom because you don't like it," House told her. "What else could fit all these symptoms?"
"How about Guillan-Barre?" Foreman suggested.
"Okay," House replied and wrote that on the board as well. "Anything else?"
"West Nile." Cameron said. House nodded and added that to the board also.
"Chase, get some blood, test her for Guillan-Barre and West Nile, and we need an LP to rule out meningitis. Foreman, do a neurological exam to see if we can confirm Bell's palsy. Cameron, go back and get a more complete history."
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Cameron entered Courtney's room. Her mother was standing beside the bed, stroking her hair again.
"Mrs. Pevensee? I need to get a more complete medical history to help us determine what exactly is wrong with your daughter." Cameron said. Cameron, Mrs. Pevensee and Courtney spent the next 40 minutes going over Courtney's history, activities, job, and school, anything that could be relevant. Mrs. Pevensee revealed that Courtney had just returned from spending a month with her father in Delaware. Courtney seemed a little uncomfortable with this, but Cameron asked Mrs. Pevensee to call him and ask him to come to the hospital.
Cameron returned to the conference room to review all her notes. There was really nothing in the history that was helpful. It was all routine childhood stuff.
"Anything useful?" House asked from behind her.
"Nothing. But she just got back from a month with her father. He's on his way here now, maybe he can tell us something we can use." Cameron sighed. She still felt like there was something about this case that was just outside her grasp and she couldn't quite reach it.
"It's not Bell's palsy," Foreman announced, taking the marker and crossing it off the board. Foreman turned and sat at the table, taking the file from Cameron to review.
"She doesn't have meningitis," Chase replied. "The results for Guillan-Barre and West Nile won't be ready for a few more hours."
Cameron's pager went off, followed by Foreman, then Chase. The three rushed to Courtney's room.
"I can't move my feet," Courtney said, clearly frightened. "Why can't I move my feet?" She was crying now.
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"Add paralysis," Cameron announced to House, flopping into a chair at the conference table. She laid her head down on the table. After Courtney had begun experiencing paralysis in her feet, Cameron had done an extremely thorough physical exam, looking for signs of insect bites or ticks. She'd found nothing.
"Aw, are we keeping you awake?" House snarked at her. He wrote the new symptom on the board, and then sat at the table as well. He reached into his pocket and shook out two Vicodin. Of course, he was only supposed to be taking one, but he was feeling anxious and needed the extra one to help him think straight, he rationalized.
Cameron lifted her head to watch him swallow his Vicodin. She raised an eyebrow at him, but wisely said nothing. She knew it was going to take more than a couple of weeks for him to break a five-year drug addiction.
"How do you know when you're missing something?" Cameron asked him.
"Well, when my hooker doesn't come over for a few days I start…" House began, but Cameron interrupted with a disgusted huff.
"I mean this," Cameron waved her hand at the board. "I've watched you do it a hundred times, you just stare at it and things come to you. How do you know?"
House cocked his head to one side and looked at her. She really was observant. He didn't want the ducklings to know that sometimes he didn't know the answer immediately. He wanted them to think he knew what he was doing the whole time, and he was trying to teach them by letting them go through the whole process.
"I'm not sure I can explain it," House answered, honestly. "It just clicks. Sometimes you have to stop thinking about something to get it. That's what that stuff is for." House indicated his Ipod and Gameboy, which he placed on the table. It was a good question. It was the sort of question she needed to be asking if she was going to learn to be a great doctor, not just a good doctor.
Cameron nodded. She'd expected an answer like that. It was something she was going to have to work on. Sometimes, after they'd figured out what was wrong with their patient, she could kick herself for not having seen it sooner. She could see the connections, but only after House had made them.
Cameron's pager went off. She checked it, and then heaved herself out of her chair.
"The father is here," she informed House, and went to speak to him. House followed a little behind her.
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"Mr. Pevensee?" Cameron asked of the man standing outside Courtney's room.
"It's Russell, actually," the man replied. "Chris Russell. My wife took her new husband's name, and so did Courtney." Mr. Russell gave a rather bitter smile. He was older than she'd expected, based on Courtney and her mother. Cameron wondered if that had anything to do with their divorce.
"Sorry, Mr. Russell. I understand Courtney was staying with you last month? I'd like to ask you a few questions about her time there. It might help us determine what's wrong with her." Cameron smiled at him, and led him to a sitting area nearby.
After speaking with him for a few minutes, Cameron got the distinct impression that he wasn't telling her something. He'd answered all her questions, and without hesitation, but something still felt wrong. As they were wrapping up, Mrs. Pevensee exited Courtney's room. She gave Mr. Russell a quick look, and then walked down the hall toward the cafeteria. Mr. Russell went immediately into Courtney's room, and began whispering to her.
Cameron stood outside the room watching them. Mr. Russell was speaking softly into his daughter's ear. What should have looked like a tender moment between a father and daughter instead looked so, wrong. Whatever Mr. Russell was saying, he was saying it very urgently. Cameron felt someone stand next to her and turned. It was House.
"He's lying to me." Cameron stated.
"Of course he is," House replied. "Everybody lies."
"So I do how I get him to tell me the truth?" Cameron asked.
House just shrugged. There were some things you just couldn't teach people. They had to figure them out for themselves. He looked at his watch; it was now past 7 o'clock.
"Cameron, its after seven," House said. "Why don't you go home? Maybe if you get away from it, something will come to you."
"Think you could get me a few minutes alone with Courtney. I need her parents out of the room," Cameron said. House smiled. She was on the right track.
"Sure," House said. "Then you're going home."
House entered Courtney's room and spoke for a moment to her father. Mr. Russell kissed his daughter on the top of the head, and followed House reluctantly.
Cameron entered Courtney's room after House and Mr. Russell had turned the corner. She wanted to ask Courtney a few more questions to see if she got the feeling the lying had something to do with her father.
"So that was your dad?" Cameron asked. "He seems like a really nice guy. Must be tough to have your parents not get along, huh?"
"It's okay," Courtney answered. "All they did when they were married was fight all the time anyway. My dad's a journalist; he travels all the time. My mom was always mad that he wasn't around; she was always yelling at him that his job was more important than us. Dad would always say he was lucky that he got to spend his life doing something he loved, and that she should be happy for him." Courtney paused. "It's better this way. My dad can travel whenever he needs to, and doesn't have to feel guilty. My mom gets to have a husband at home most of the time, so she's happier too."
"Where's your step-dad now?" Cameron asked.
"He had to go to a convention. It's the only one he goes to every year. Figures it's when I'd get sick. I hope my mom isn't mad at him." Courtney spoke quietly. "Do you think she'd divorce him over something like that?"
"I don't think so," Cameron said soothingly. "If it's the only time he travels all year, it's just bad timing, that's all." Cameron sighed. This wasn't getting her anywhere. She didn't feel like the girl was holding anything back about her parents. Cameron noticed an unusual necklace Courtney was wearing.
"That's a really pretty necklace," Cameron commented. Courtney's eyes lit up, then quickly darkened.
"Thanks. My dad got it for me for my birthday." Courtney replied, shortly.
"We're did he get it?" Cameron asked
"I don't know, he didn't say." Courtney replied. "I'm kind of tired. Is it okay if I get some sleep?"
"Of course," Cameron answered. "I'll come in to check on you in the morning."
