When House crutched into his office a few hours later, Morgan had already put the scans up ready to be evaluated by the two doctors. The orthopedist nodded towards them without preamble.
"It's a partial tear of the ACL, just as expected based on the clinical picture… The menisci are fine, fortunately, as are the other ligaments. No indications of any fractures or dislocations." Then he gestured towards another scan, clearly depicting the thigh right above the knee, no longer the joint itself. "We also took a look at the rest of the leg, due to the rather diffuse pain you experienced earlier. – There's a strain in the lower thigh muscle, rectus femoris; grade I, from the looks of it… The ankle is okay; everything else looks okay as well."
House seemed a little annoyed for some reason, but kept himself from commenting. Instead he just mumbled in Morgan's general direction: "So… Treatment?" He looked distinctly uncomfortable, though the orthopedist had no idea why. – He decided to focus on the medicine for now.
"We should keep the leg braced for a while. – Does it still feel okay?" He nodded towards the leg that he had fitted with a whole-leg soft brace earlier. House just gave a clipped nod in response. "Good. – I don't recommend surgery in your case; for an ACL injury, the knee is still relatively stable. Some rest and then a few weeks of physio should be enough to further stabilize the joint and prevent any additional damage."
Studying his patient for a moment, he finally continued more quietly. "Both the old and new thigh injuries of course complicate matters some, but at least the acute strain should heal fine within a couple of weeks. The physio protocols will need to be adjusted to accommodate your previous injury, but all things considered, I would expect you to make a full recovery in about 6 to 8 weeks." He paused briefly to stress his next point. "But you do need physio for this, House, at least if you wanna avoid surgery. An ACL tear – even if it's a partial one – doesn't just go away on its own…"
When House just nodded briefly again and started moving towards the door without another word, Morgan frowned and held up a hand. "House! Wait a minute; we still need to talk medication."
"I'm on pain meds already, thanks." He had already reached the door.
Morgan quickly put a hand on one of his crutches, effectively stopping his progress. "That need to be adjusted, at least temporarily. You were in a lot of pain earlier…" He kept his voice gentle; calm.
"There's hardly even an injury! I'm fine." The anger was back, and this time Morgan thought he understood what this might be about really.
He narrowed his eyes.
"You don't think an ACL tear is an injury…?" Incredulously. Then: "The ACL is the most important – "
"Oh, relax. I didn't mean to offend your precious ligament. – I know it's an injury. Just usually not a very painful one."
"There is no 'usually', House. And you also have a muscle strain, in case you forgot."
"Oh, boohoo. Grade I. Poor me. There's almost no coming back from that one, is there…"
This time, Morgan started to wearily rub his forehead, feeling completely out of his depth in this conversation.
"House…" He somehow managed to say the name and sigh at the same time. "One third of your thigh muscle is missing and you have severe nerve damage in a region that's directly connected to two soft-tissue structures of your leg that show actual, acute tears right now. It'd be a miracle if your pain levels weren't significantly up." There's nothing to be ashamed of. – He didn't say that last part out loud, obviously, but he hoped it was heavily implied…
When the older man didn't reply anything, but also didn't move any further, he continued in a quiet, yet firm, voice: "This needs to be addressed medication-wise. There's no reason to stress your system with an undertreated pain situation. And once the Demerol wears off, I suspect you'll be agreeing with me…"
Without waiting for a reply, he went over to his desk looking for his prescription pad. "I'm writing you a script for oxycodone, which I think you should fill, but it's of course your decision." He looked up at his patient again who had at least turned away from the door for now. "I assume you've already started yourself on Ibuprofen?" Just a nod. "Keep taking it at least for the first week. – You want some omeprazole with that?" House shook his head no, once again uncharacteristically quiet now. "Okay, but don't forget to eat regularly with it then… Also, keep applying ice today and tomorrow. Keep the leg up as much as you can. On Monday, I suggest you start with some mild physio. You can do that here with us, if you'd like, or I can write you a referral."
House just nodded briefly. "'Kay. – Thanks."
Morgan narrowed his eyes slightly. "Does that mean you'd like a referral?"
House threw him another semi-annoyed look at that, before once again averting his gaze. "Can't really leave the hospital anyway, so I might as well make use of the local infrastructure. – Guess there's only so much even your guys can screw up with a muscle strain…"
Morgan couldn't help but roll his eyes at that. "Wow, ringing endorsement, House. Thanks so much for your trust in and appreciation of our services..." He joined his patient again now to hand over the prescription. Briefly holding onto it, he waited for House to reluctantly meet his gaze. Then he simply nodded slightly. "Okay then… See you on Monday."
