"To Have and Have Not"
Chapter Two – "Not Having Any Fun"
By: purpleu
"Get down to the ER; Bell's coming in with a possible stroke," House said grimly as he and Lydia hurried through the maze of hallways that led to the emergency room. He had called Chase, not even bothering to say that the entire team should come down; he knew they would follow automatically. Everyone arrived at the ER desk at the same time; the nurse informed them that the ETA on the ambulance was four minutes.
"What happened?" Chase asked.
"Don't know the full story yet. He was in a Dunkin' Donuts… he began slurring his words, but got out my name and the name of the hospital before he finally became unresponsive," House said. "Need to find the PA that called me… "
"Dr. House? I'm PA Connor… I called you," a young man standing behind House said. "Mr. Bell appears to be doing relatively well, vitals are quite stable. The ambulance is reporting his pulse as 65, respiration as 20, BP 107/62 and O2 Sats at 97 percent." House frowned.
"More than pretty decent for an old guy who's just stroked out," he noted. "Was there drooping of the face or weakness on one side?"
"They didn't report any specific symptoms like that; they simply said he was acting consistent with a stroke."
"Which leaves an open door for all sorts of things to come wandering in asking to be considered as a cause for the symptoms," House noted.
"I don't even see why he was getting anything to eat," Lydia said. "He was supposed to be meeting Annie for lunch in half an hour; she and James had a mini-wedding album made for him as a thank you for performing their ceremony. They were meeting so she could give it to him." House looked toward the bay doors where the ambulance would be pulling in; a police officer had come through them surveying the ER like he was looking for someone.
"I know this is a usual question for a cop, but did you just come from a donut shop?" House asked as he walked over to the man. The ID tag he wore said Davis, and he managed a smile at House's inquiry.
"I take it you're Dr. House," the policeman said. "The gentleman that we found was in bad shape, but he made sure we knew to bring him to you. He was badly slurring his words and was leaning over to his left side, although he managed to take out his wallet and this card." The officer handed House something the size of a business card. It read, "In case of an emergency, I am to be taken to Princeton Plainsboro Teaching Hospital, and Dr. Gregory House is to be notified at (917) 555-0611. No allergies to either food or medicines." "All of that info is great, but he should be wearing it on a medic alert band, not digging for it in his wallet," Officer Davis remarked.
"We've tried to get him to wear one because he has high blood pressure and is on medication for it," Lydia said. "But he says other than his wedding band, he's not a jewelry person."
"No. what he said was, he didn't want to look like Mr. T," House noted. Officer Davis shook his head as he held up the backpack he had in his hand. "Mr. Bell's wallet and keys are in there and what looks to be several medical files; his coat's with the ambulance crew. He had parked in the handicapped spot at the store; that's where his car is now."
"Where the hell is the ambulance?" Chase asked. "Connor, what's the ETA on the ambulance bringing in Reverend Bell?" Connor looked confused by Chase's use of Bell's proper name, but he got on the radio to the EMTs.
"Another three minutes; they got caught up in the road construction coming off of Route Three." Lydia saw that the cop was still holding Bell's backpack, and took it from him. He surrendered it hesitantly.
"Are you a family member of Mr. Bell's?" he asked.
"Reverend Bell," Lydia corrected. "And he's Dr. House's father." She handed the pack to House, so he could review the files it contained.
"And your relation to Dr. House is… " he asked Lydia. Davis was uncomfortable as the bag was passed from one person to another.
"Who? Us? We have relations all the time; every chance we get in fact," House snarked. He was not happy with the delay in getting Bell into the ER and under his care.
"I need someone to sign for the bag," Davis said. House grabbed the clipboard the cop was holding and made a giant "X" across the entire page. The policeman scowled at him, but then seemed satisfied when Lydia signed the document. As they waited, House saw that in and among the medical files that Bell had from Virginia were results from a current exam. Other than his blood pressure being just slightly elevated, the labs that were run on him were good. Pulling more papers out, House saw the name of the facility the tests came from, Crestwood Advanced Care. He frowned as he returned the items to the backpack.
"Why didn't Bell pull over and call 911?" House asked. "Why go to a donut shop if you're getting ready to meet someone for lunch… " Lydia shook her head, trying to think of answers to House's questions. The team was silent, too. Suddenly, they saw "The Look" come into House's eyes; the always occurring epiphany.
"What was on the table in front of him when you found him?" House asked the officer.
"Some juice and some donuts," Davis replied.
"Juice? Thomas never drinks juice except when he takes his vitamins at breakfast," Lydia said. "And as I said before, he was about to go have an early lunch."
"What kind of donuts were they?" House asked the cop with intensity. His demeanor threw the officer off.
"What kind… what difference does it make?"
"Just answer his question," Lydia advised. She knew how her boyfriend could be when he felt he was dealing with stupidity; obviously House had a reason for asking the question.
"He had two bottles of apple juice; one was empty, but I think most of it spilled on him. And there were two Boston Cream donuts, each with a bite taken out."
"Something's wrong with that," Lydia quickly said. "He always gets coffee with his donuts, and he gets the plain, Old-Fashion type so that he can dunk them."
"He got the sweetest donuts he could think of. He was trying to get as much sugar into himself as he could," House noted. "Get on the horn… tell the EMTs to do a finger stick on Bell," he called out to Connor.
"They… they should be here in a minute," the PA replied.
"And they'll be bringing in a corpse rather than a patient if we don't get that reading," House snapped. Connor hurried to do as House instructed.
"Start a line on him as soon as he's out of the ambulance; have two 1cc syringes with dextrose standing by, along with a bag of D5W," House ordered his team. He took a deep breath. "Have an intubation kit and defibrillator ready in case we need it." The team scattered to retrieve the supplies House requested.
"Dr. House… the EMTs can't get a reading on the patient. I don't know if he's that hypoglycemic or if they're having trouble with the machine," Connor reported.
"Where's a kit from here?" Lydia asked. She would grab it and have it ready to get a reading on Bell as soon as he came through the doors.
"Who's got the Accu-Check?" Connor called out over the din of activity in the ER.
"You've only got one?" questioned Chase as he passed by the PA while coming back from the supply area with the IV equipment.
"Afraid so. We've requested additional, but haven't gotten them yet." House quickly surveyed the room; he saw an aide headed to a patient's bedside with the machine in her hands. Whether she didn't hear the request for the machine or ignored it, House didn't care. He strode over to the stretcher where the aide stood and snapped the lid closed on the testing unit.
"Hey!" she protested. "I've got to do a finger stick on this patient and see how high his sugar is." House leaned over to the startled middle-aged man who occupied the stretcher.
"Breathe on me." The man looked flustered. "Come on… Listerine only paid for a fifteen second commercial… breathe!" The man did as House ordered him to. "He's easily over five-hundred, and has been for a while." House started to walk away with the unit.
"How… how do you know that?" asked the aide, not sure what to make of this man who was stealing her precious glucose monitor.
"I graduated from Hogwarts," House yelled over his shoulder as he headed back to meet the now arriving ambulance. "Slytheryn."
"It's OK," a PA said to the aide. "It's obviously badly needed over there. We'll get the unit back and get a real reading in a little bit." He leaned over, took a whiff of the patient's breath, and frowned. "Go see if you can borrow the one from Pediatric ER." He shook his head in amazement as he watched House disappear to the other side of the room. Arriving at the bay doors just as Bell was coming out of the ambulance, he quickly set the machine down and got it ready.
"Bed five!" a nurse called out.
"He's making a pit stop," Housed said placing a hand on the right side of the stretcher. House's team moved in and did a rapid search for a vein to start an IV. They found one on the back of Bell's left hand while House did the finger stick test. He was not happy with the reading the machine gave him… not in the least.
"We need the line in… now!" insisted House. Lydia stepped in and removed the glucose monitor from the scene before it hit the floor.
"Almost… almost…. Got it!" called out Chase. "Back flow… ready!" House had come around to stand next to Chase; as soon as the line was ready, he practically pushed Chase out of the way. He grabbed the access portal on the line, and taking one of the syringes Taub was holding, House pushed one cc of dextrose in; he then did the same with the other syringe.
"Both of them?" Thirteen questioned. House nodded as he looked down at his father's face.
"His glucose was twenty-three. He didn't have much room left to play with. Get the D5W hung up."
"Oh my God!" Lydia exclaimed. "He must have felt there was a problem and knew how to handle it… just not in time to avoid this. But… he's neither a diabetic nor a hypoglycemic."
"Seems he's something right now. He and Mom had a friend down in Virginia who was a type 1 diabetic. The guy was either not well-educated in his care or just didn't give a damn. They were always scraping him up off the floor or taking him to the ER for another admission. I met him when I was working with Bell on my mother's estate; the signs of improper care were obvious." He saw that Thomas was starting to move his head slightly. "Get him down to slot number five. I'll be right there." House realized that the PA whose patient he had taken the glucose meter from was standing nearby. "How'd I do?" The PA smiled.
"Five-seventy-five," he responded. "Nice call." House nodded.
"When a patient reeks of acetone, DKA is obvious. Either that or he swallowed a bottle of nail polish remover." House headed over to cubicle five; as he looked down at Bell, he could see he was trying to open his eyes.
"Hey… you can stop praying now… you're still among the living." Bell's eyes fluttered open at the sound of House's voice.
"Do you know where you are?" Chase asked.
"Princeton Plainsboro Teaching Hospital," Thomas replied weakly. "And you're Dr. Robert Chase." His response drew a smile from everyone gathered around the stretcher.
"What's your name?" House asked. Thomas turned to him.
"From you, I would prefer Dad, but Thomas, Reverend Bell, and hey you, work just fine for me." House feigned looking annoyed, but he was genuinely relieved that Bell was talking.
"He seems to be lucid," Taub said with a laugh. Lydia was smiling, but she was also concerned about what prompted the situation.
"Thomas, I know you said you were going to find an internist near where you live for minor medical issues," she began. "I don't blame you since Greg and PPTH are an hour away. Have you been to see him yet?"
"Yes, I saw him Friday."
"Did he change any medications on you? Give you anything new?" Thirteen asked.
"No. He said my blood pressure was acceptable on my current medication, so there was no need to change it. He just gave me a script to renew my LisinopriI which I've been on for a couple of years now. I'm shocked by all of this… I've never had any problems before."
"And you didn't have any problems when I looked at these same records back in October," House said holding up Bell's medical records. "And the tests they ran last week were all good. Of course, we're going to repeat them here to validate them. Who's the doctor you saw?"
"Dr. William Stewart oversees everything at the facility, but I didn't actually meet him; I saw a PA and a nurse practitioner." House rolled his eyes as the team and Lydia shook their heads.
"Was this one of those immediate care centers that you go to with a sore throat when your own doctor is too busy to see you?" Chase asked.
"No, this was a satellite office of a geriatric practice. Several of the people who live in my development have used them. As you get older, you have little patience to sit around a doctor's office or a hospital office just to get a prescription renewed. I knew… I mean I thought… that I was healthy enough to just have this facility be someplace I could go to with a simple problem like a sinus infection or something. I just wanted a basic primary care physician." Bell looked around at House and the team. "You all take care of complicated, intricate cases; it's not just about the distance… I didn't want to waste your time."
"Rather waste my time with simplistic medical problems than another funeral," House said giving Bell a look. "Besides, until we figure out what happened to you, you've entered the twilight zone of weird medical cases."
"What lab did they send you to?" Chase inquired. House had passed around Thomas' file and he had noticed that the lab reports had only the name of the facility, Crestwood Advanced Care, on them.
"The lab was within the building that I went to; right in the same office, in fact. They also have an x-ray unit there."
"Sounds like a miniature version of a hospital," Taub noted.
"Are you sure this place is legitimate? Because it's beginning to sound like something that could be run out of the back of a tie-dyed VW bus," House said.
"A lot of these specialty clinics have been popping up," Thirteen observed. "One will administer treatment for arthritic joints, another spinal compression, some are pediatric, some geriatric… all with the purpose of having people avoid long waiting times in traditional offices. I read an article about this growing trend a few weeks ago. The problem is, while the staff is legitimately licensed, you're not seeing an actual doctor."
"I guess those facilities might have their place," Lydia noted. "It's just rather odd that after Thomas' first visit to one, he winds up here with a rock bottom glucose level. Even though it does seem they didn't make any changes to prompt this." Thirteen nodded in agreement.
"I tried to do the right thing and get sugar into me… I guess it just wasn't enough or fast enough," Bell said sadly.
"You had the right idea," House said. "But with a twenty-three blood glucose, you could have given Dunkin' a new and unplanned drive-thru." Bell's eyes opened wide.
"Twenty-three? Dear God! I could have killed someone!"
"Like yourself. Any lower, and you'd be preaching from the big pulpit in the sky," Lydia said gently rubbing his shoulder. Bell nodded and closed his eyes.
"Hey… what's going on? How's Thomas?" Foreman approached bed five with a concerned look on his face.
"Now that his blood sugar is over the age of consent, he's doing better," said House.
"What? Annie called Wilson and said that Lydia texted it was a stroke."
"That's what we were told at first," Lydia said. "It turns out his blood sugar was only twenty-three."
"What the hell caused that?"
"Haven't figured that out yet," House said as he tapped the handle of his cane against his lips. "Let's start with the usual score sheet… SMA 20, CBC with differential, lipid panel… add in an A1C so we can see what his glucose has been doing for the past few weeks. Get an EKG, chest x-ray… do an EEG to make sure there was no seizure. Pull an abdominal ultrasound with contrast and take a look at his pancreas. And an MRI."
"Insulinoma?" Chase asked. House nodded. Bell looked confused and concerned, but it was the slightly puzzled look on Lydia's face that had House's attention.
"Come on. You know what it is… or at least can figure it out," he chided.
"I'm going to say it's a growth, a tumor on the pancreas. It probably rests on the beta cells which would interfere with the correct amount of insulin being produced," Lydia ventured.
"And despite its name, it's rarely cancerous," said Wilson as he and Annie approached the group. "Why are you exploring that line of thinking? Last I knew it was a stroke. What's going on?" House filled him in on Bell's glucose readings when he came into the ER. "Whoa! That is as close to the danger zone as you'd want to get. So you're looking at an endocrine issue. You know Slick's still licensed to practice if you want his take on anything, especially since that's his area of expertise."
"Already had that thought flash through my mind," acknowledged House. "We'll see if we need him." Annie, who had been just standing by listening, now squirmed her way in past House to get next to Thomas' bedside.
"You know, if you didn't want to have lunch with me, there are easier ways than this to cancel," she said with her hand on her hip.
"I would never break a lunch date with a lady as sweet and lovely as you, my dear. I… I don't know what caused this; I'm upset… and scared." Annie took his hand to try and reassure him. House kept his poker face on, but he wasn't happy hearing that Bell was upset, although he couldn't blame the man. Depending on what test results show, surgery may be necessary; a scary option for a person Bell's age, even if on paper, he seemed healthy.
"Best thing to do right now is get the tests going," Chase said. "Connor just came over, and I told him we'll be handling things with Thomas. Do you want him in ICU or on a regular floor?" House thought for a moment.
"Let's get him to ICU. His sugars are going to have to be checked more frequently that the usual protocol of once every four hours; the staff up there is better able to handle it," he noted.
"House, mind if I play doctor for a minute?" Foreman asked.
"Sure, as long as Thirteen's willing, who am I to stop true lust?" Thirteen merely smiled; Foreman shook his head.
"At some point in the future, I was going to suggest a CT with contrast… just for a baseline look at things. You're going to have an EKG, a chest x-ray, the blood work-up, EEG… hate to say it, but he does have high blood pressure as I remember it. It'd be an idea to do the whole package."
"We can have him come back in for that one. Hypoglycemia and CTs with contrast don't play nicely," House noted. Foreman agreed.
"No… oh… no… " Thomas started to say.
"Thomas… Thomas, are you OK?" Annie was still by the bedside, but hurried out of the way as House and the team moved in. Everyone had been so busy talking, they weren't actually looking at Bell much in the past few minutes. Thomas slowly shook his head.
"I… low… " he managed to get out. House leaned over and increased the drip rate on the D5W.
"Dextrose and the monitor," House barked out.
"Got the dextrose," Foreman said running off. Chase saw the Accu-Check on the counter around the corner and rushed over to grab it.
"Need you to try and stay conscious," House said to Bell as Chase set up the machine. "Come on, keep talking… hit me with your best sermon!" Thirteen saw that Thomas' breathing had become labored. She crossed behind House and got the oxygen mask off the wall. Taking off the nose clip unit that the ambulance had hooked Bell up to, she placed the mask on him.
"I've got a second bag of D5W to piggyback on," Taub called out. Just as Foreman made it back to the stretcher, Chase announced the glucose reading.
"Thirty-one!" House took the dextrose syringes one by one from Foreman; he had brought over five, and House wasn't entirely sure that more wouldn't be needed.
"Keep talking to him! Get him to respond!" House yelled. Lydia moved to the end of the gurney.
"Thomas can you hear me? I want you to nod your head if you can hear me. Or say something if you can." While Bell slightly moved his head, he was verbally unresponsive. Thinking quickly, Lydia knew how to get him to talk. "Thomas, come on… it's time to pray." Lydia began the Our Father, moving closer to the side of the bed as Chase joined her in the prayer; years after leaving his studies at a seminary, and he still knew it. Bell started to join in at the end.
"…now and forever. Amen." The three finished together, but Thomas fought to get his words out.
"What the hell is going on?" Wilson asked House who had stepped away after emptying the dextrose into Bell. "Insulinomas don't form overnight. He would have had some earlier indications."
"Not if it hadn't reached the beta cells yet," said House. "Raise his head up; see if he can drink water." Lydia was nearest the head of the bed and elevated it until Bell was in a comfortable position. Taub had piggybacked on the second D5W while Thirteen got the water.
"Can you hold this, Thomas?" she asked, offering him a cup.
"Yes." He took several small sips, then a regular-sized drink. When House saw Bell handled it, he decided to take it a step further.
"Get him juice; let him take it through a straw so he doesn't choke. Keep it coming as you do the tests and blood draw. Tell dietary that he's on a high carbohydrate diet. Check his glucose every thirty minutes. Call me when you're ready to do the tests." While no one said anything, they all saw House let out a deep breath as he moved away from the stretcher. The team simply nodded. As Chase left to pick up Thomas' paperwork and sign him out of the ER, House turned to leave.
"Greg?" House faced his father; the old man looked like he had aged just since arriving at the ER. "I'm so sorry for all of this bother for you and your team. This is precisely what I was trying to avoid." House began to tap his cane on the floor.
"For now, I'm going with that all-American principle of innocent until proven guilty; I'm guessing you did nothing to bring this on yourself. This is one of those big 'oopses' that the body pulls every so often. It keeps the bunch of us out of trouble and off the streets at night," he said indicating the team. "We'll probe the hell out of you and figure out what this is."
"Just be a good patient and be co-operative with whatever Greg's team tells you to do," Lydia said, coming over and rubbing Bell's cheek with the back of her hand. "You know they'll take good care of you." Thomas nodded.
"Yes, I know they will. They're a talented group of doctors… or they wouldn't be working for Greg. And they're good people, too," Bell said looking around and smiling.
"And what they can't handle, I can," House said twirling his cane. He looked back at Thomas and let his guard down for just a moment. "Behave yourself," he said with a softer tone in his voice.
"I promise not to do anything that you wouldn't," replied Bell with a smirk.
"Damn, we're in trouble," Taub said with a straight face. Everyone chuckled as House glared at them all.
"Just remember who signs your paychecks," he countered to his team.
"For now," Foreman said under his breath. House shot him a look; he didn't have the chance to talk to Chase, Taub and Thirteen yet about the behind the scenes political and financial malarkey that was going on, and he didn't want them to hear it from anyone else.
"See you after you're sufficiently poked and prodded." House said as he turned away.
"Check on you later," Lydia said giving Thomas a kiss.
"I'll have Lydia keep me up-to-date," Annie said waving.
"Be up in a little while," Wilson said with a wave. As they moved away from the gurney and toward the doors back to the hospital, the three looked at each other. House was walking with his head down, his brow knit deep in thought. About half-way back to the lobby, Foreman caught up with them.
"So, how radical are the purse-string holders looking to be?" House asked. He wanted to focus on another puzzle until he had more information to use for Bell's case.
"Well, if it were up to Durbin, he'd knock this place down and put up a parking lot, to paraphrase Joni Mitchell," Wilson said. "His approach seems to be two-fold; that there was too much financial mismanagement for this place to recover, and that these… micro-care centers that are popping up all over can reduce the public's need for us."
"How much support does he have on the board, and how much pressure can he bring? Because to me, this fellow sounds like that guy Vogler who created trouble for everyone a few years back," Lydia noted.
"The difference with Durbin is he's not looking to become a big shot around here," Foreman said. "He's got higher, political ambitions and is trying to paint himself a savior of the common people when it comes to health care issues. He's using the mistakes that have been made around here and at Princeton General to further his cause."
"He's on the board over there, too? Just how far is Elastic Man's reach?" questioned House.
"I don't know that he's on the board at PG, but he's including them in the shameful behavior label since they lost their rating as a level-one trauma center; we've kept it… for now," Wilson noted. "One of his targets is the clinic… and if that gets shut down, our level-one rating is history."
"Makes sense; from what Thomas said, it sounds like these satellite offices are copies of the clinic here, except not under the auspices of any hospital. Has the state medical board weighed in on this new trend?" Lydia asked.
"The good news is that the majority of the state board members aren't all that impressed with them; the bad news is they are more concerned about what's gone wrong here," said Foreman.
"James has mentioned to me that there seems to be a lot of theft… supplies and equipment walking out the door," Annie said. "Over at the college we've experienced the same thing. But it was easy to break up the group that was taking things because face it… a cello or a tuba don't exactly fit in your pocket. Is it possible to get some sort of security or investigation service in? It'd mean spending some extra money up front, but it could be of a great benefit in the long run. I know that's what we did at the college." The group made a turn down a hall that would lead them to the lobby.
"It's something to consider," Foreman said looking at Wilson.
"The holes have to get plugged up somehow," said House who had been very quiet. "Having to play hot potato with the only glucose monitor in a department is just one example of what delays in care may result in. Including fatal mistakes. Who knows what mayhem could result if we lacked in defibrillators or any other necessary equipment around here." Lydia glanced at House and then Wilson; they both knew he was thinking about Bell.
"That's just one of the problems we're dealing with. I hate to ask this at the moment, given what's happening with Thomas… but we could use your help, House," Foreman said with a sigh. House stopped, turned, and grimaced.
"I don't do bureaucracy, nor do I play nice with pencil-pushers. I don't even like to talk to patients, or have you forgotten my usual M.O.?" Foreman managed to laugh.
"House, as long as I live, there is no way I will ever forget you… but not necessarily for the right reasons. Look, you still have a connection with Jeanne Hunter and her boyfriend, correct?" If possible, House frowned even more deeply. The mention of anything to do with Malcom Hunter, the corrupt attorney who tried to ruin his team's and Wilson's careers, never thrilled him. The only exception he held out was for Hunter's son, Tyler. Hunter tried to use his son as a pawn in his battle with House and in the process, ignored the child's true illness. House was able to peg that the boy had the most severe ailment in the Autism Spectrum, Childhood Disintegrative Disorder, and the boy finally got the proper help. Jeanne Hunter was now Malcom's ex-wife and she and her boyfriend Jeff were both on the Board of Trustees. House e-mailed them occasionally to check on the boy.
"Correct. But only for the purpose of monitoring the kid's status. I send the mother an article if any advances have been made in the kid's disease, but that's few and far between."
"We know how Jeanne and Jeff feel in reference to Durbin and his ambitions," Wilson began. "But if they could give us an idea of how much the board is listening to this… idiot, then we could ignore him and try to make the corrections necessary to keep the hospital going."
"What do you mean… there's a chance that PPTH could close?" Lydia asked incredulously. "That's… absurd! Princeton Plainsboro Teaching Hospital is known the world over, as is many if its staff," she said looking at Wilson and House. Foreman dropped his head down.
"Please keep this confidential, but the word came down from the State Medical Board this morning. We've got two years to try and stop the bleeding financially. For now, closing is only an outside possibility. Disappearing equipment and supplies have to be cut down to a minimum, there has to be a hiring freeze with personnel cutbacks made, more donations have to be solicited, and more doctors have to send their patients here. I'm sure Thomas won't have to wait long to get a bed," Foreman noted. "Things never used to be like that around here. We need to do all the things that are required to make this place as self-sufficient as it used to be. And there has to be a continuation of the increase of payments from insurance companies… but the insurance department is one area we are not worried about right now," Foreman said giving Lydia a smile.
"Oh, sure… no pressure," she said rolling her eyes.
"Hmm… two years, huh? Damn, that messes things up," House said as they neared the lobby. "I was so hoping to make my silver anniversary here. I had a party planned with booze, a hot tub, wild sex and everything." Lydia shot him a look, which he noticed. "Did I forget to mention it'd be a one on one private party with you as my only guest?" he asked with a smirk. Before Lydia could answer, a man's voice drifted toward them from the lobby.
"Is that someone… preaching?" Annie asked.
"No, politicking," her husband replied. "You have got to be kidding me." As the five of them entered the lobby, they saw a man standing to the far left side with a small crowd around him. Some were obviously from the media, their cameras clearly seen. Others were merely curiosity seekers.
"The people of this state deserve health care that isn't too big to focus on their needs," the man proclaimed.
"Chuck E. Cheese Durbin?" House inquired.
"Yep… I'm afraid so," Foreman said looking very unhappy at the commotion going on in the hospital lobby.
"Can he just come in here like this… disrupting the place?" asked Annie.
"He's a trustee… you'd be amazed at what they can get away with," Wilson replied.
"I'm not pointing blame directly on the current or the prior administration here," Durbin continued. "There were mistakes made; whether they were made due to poor judgment by Dr. Cuddy and the staff or if their bad judgments were made due to misinformation, I don't know yet."
"Wouldn't be the first time she made a bad call based on bogus information," House muttered under his breath. The people standing with him knew he was referring to the operation on his leg years ago. House looked over his left shoulder, aware that the team had come to join them in the lobby.
"Bell's glucose is up to seventy-five. He's going to room four in ICU," Chase said quietly. "Drinking apple juice while being transported." House nodded.
"What I think should be done is a streamlining of functions around here," Durbin said in response to a question. He looked over to where House and the team were standing. "For instance, there's a Diagnostic Medicine Department here. Now, I know the department does incredible work, and its reputation and that of the doctors who work for the department is impeccable and well-known. But really… isn't it the job of every doctor to diagnose their patients? Isn't that what they're here for in the first place? Why do we need to spend excessive and unnecessary money on a department that duplicates the work the hospital is already doing?"
"Son-of-a bitch! Who the hell… " Chase exclaimed.
"Not the time," House said, never taking his eyes off Durbin.
"I'm not here to make specific proposals; I'm simply letting you know that as a board member, I will be diligent in seeking ways to correct the problems of the past and prevent the problems of the future. And I will bring those solutions to the entire state so that all the citizens of New Jersey will receive proper health care. Thank you." The press conference began to dissipate as Durbin made a hasty retreat to the hospital doors. House turned to Foreman and Wilson; he was clearly peeved by Durbin's speech.
"I'll contact Hunter's ex tomorrow. This guy just went from being annoying to being on my Do Not Piss Me Off Like That list," House noted.
"Who the hell is that guy?" Taub asked. "And why does it sound like he wants to get rid of our department?" This was definitely not the way House wanted to discuss the situation with the team, but now that the cat was out of the bag…
"Get up to Bell. I'll be there in a few minutes to fill you in on our modern day trust-buster." Chase, Thirteen and Taub looked at each other; they were anxious for more information, but they knew their patient took first priority, especially considering who he was. They took an elevator that had just arrived and left the lobby.
"I think you can understand why we need to know what we're dealing with as far as the board goes," Foreman said to House. "If there are only a few listening to him, and he's more just making noise for his own purposes, we can proceed one way. But if too many people start asking too many questions and demand immediate actions… things around here are not going to be pleasant for anyone. I won't be able to protect Diagnostics."
"Hell, I may not be able to protect the Children's Cancer Center here," Wilson said ruefully. House put his head down as he considered their words. This was clearly not something that he felt well-equipped to do, but he knew what resource to tap for help.
"I'll consult my expert in diplomacy," said House as he picked his head up and looked at Lydia. "She's far more skilled at it than I am; maybe she can give me some hints, especially since I'll be dealing primarily with the ex-Mrs. Hunter… she liked you." Lydia shrugged.
"We were both mothers being protective of our children when we met. I didn't have full custody yet of Ben and Elise, and she was trying to find out what was wrong with her child despite her bully of a husband. We could relate to each other."
"Whatever you can find out, House… Wilson and I would appreciate it very much," Foreman concluded. House said nothing, but remained thoughtful in appearance.
"Hey, since Thomas stood Annie up for lunch, we were just going to run out and grab something quick," Wilson said trying to lighten the mood. "Anyone want to join us?"
"Thanks, but I'm going to get back to those reports we were reading," Foreman said.
"Come on… you've been staring at them all morning. You need a break," Wilson pointed out.
"I… I don't want to intrude… "
"They're married and she's already pregnant; I don't think you'll be interrupting the lovebirds," House remarked. "It'll probably be a while before they get a slot open for Bell to have all of the tests." Foreman looked surprised. "You said you wanted to play doctor; might as well grab the opportunity while it's still available." Foreman did his best to hide a smile; every once in a while House managed to act decently toward him. It never lasted long, but he appreciated it when he did.
"OK, I'll tag along with you two. Give me a call when you're down in radiology," he said to House. Foreman headed off to the office he shared with Wilson.
"I know better than to ask you to come out," Wilson said to his friend. "You're going to keep an eye on Thomas. Lydia, any chance you want to grab something to eat?"
"Come on, sweetie. You look like you could use a break," Annie said. She frowned as she looked at her friend. "Are you OK?"
"My stomach's been bothering me on and off for a while now… since before the holidays. It's just never been terrible enough to worry about. Plus, I have a headache and I'm really tired," Lydia explained as she shook her head.
"At least it didn't act up over the weekend," House said, "And as far as being tired… that's my fault. I wore her out." He and Lydia both managed slight smiles despite the way the late morning had gone.
"I'd would have thought that… both of you would be worn out," Wilson said. "From the few pictures you sent us, you two were all over the city."
"We have plenty more to show Friday night," Lydia said. She glanced quickly at House, then continued. "When you come over for dinner, there are some things we wanted to discuss with the two of you. Things we should have gone over a while ago about the children." Wilson and Annie looked at each other and smiled.
"Great minds think alike," Wilson observed. "We were talking about that same subject this weekend. It's time to get certain subjects addressed and arrangements written down." Lydia smiled and nodded.
"Sounds good. You two go enjoy lunch. I'll talk to you later," Lydia said to Annie. Wilson and Annie walked away as House headed to the elevators. Lydia wasn't sure whether to follow him up to Bell's room or not. She was anxious to find out what had happened and help if she could; but she also had her own department's work to attend to. As she came alongside House, he gave her a quick glance.
"You're coming up?" he asked.
"I can if you need… or want me to." House looked down at the floor as they waited for the elevator.
"You're more than capable of offering help, but I'm going to need to focus on the medicine and not the person I'm treating. In order to do that, I'll have to be my usual self; it won't be a pretty sight," said House. "You've seen me mock and berate other patients; you won't like it if I have to do that with Bell." The elevator arrived, and Lydia entered the car with him.
"You've done that with patients who lie to you or are blatantly stupid. I don't think Thomas fits into either of those categories. Truth be told, I have a file that I have to review and get out to Lincoln Health Care this afternoon. I think it's just going to be a matter of nicely telling them that they don't know their ass from their elbow, but it's a hefty amount in dispute and I'd like to try and resolve it as soon as we can." The elevator arrived at the second floor where the ICU was situated. House and Lydia exited onto the floor.
"Yeah, every penny you can snag for this place is one more piece of gauze available for someone to pocket and walk off with," House snarked. Lydia rolled her eyes.
"With any kind of luck this Durbin character will leave them alone and let James and Eric try to figure out how to get the hospital back on its feet," Lydia said. "I'm going to head back to my office. Call me if there's any news." House nodded and watched as Lydia descended the steps to the right. Part of him wished he could just follow her and find a place to hide. This was the third time in recent history that House was dealing with a patient he gave a crap about for a reason other than the medical issues they presented. The first time was when Wilson, Lydia and Annie were mugged, and Wilson was badly wounded when he was shot. The second was Alvie and the life-threatening form of dengue fever he had contracted. Now he was dealing with Reverend Bell… his father. House had acknowledged his parentage, and was even beginning to not mind the elderly man visiting as often as he did. The kids loved interacting with him, and he and his father had more than a few good chess games and discussions with a glass of Macallan's after the little ones went to bed. House knew this was no time for any trace of sentimentality that he might possess to come to the surface; he had to keep a clear head in order to help Thomas. House made his way to room four; Chase, Thirteen and Taub were in the middle of the initial exam.
"Figure it out yet?" he asked as he entered the room and plopped down into a chair. All turned to look at him.
"You're not funny," Thirteen said as she listened to Bell's heart and lungs. "Lie down, please, Thomas." Bell complied by lowering the head of the bed, and she moved the stethoscope to his abdomen. Satisfied with what she heard, she began to press in, feeling for any enlargement in the liver or spleen. "Everything sounds and feels good," she reported. House saw that they had already hooked him up to the bedside monitor and that the numbers were well within normal range.
"Here's his EKG," Chase said handing House the printout of the reading; again everything perfect.
"He's sweating," Taub noted. Thomas nodded, and pointed toward the juice cup the team had moved away in order to examine him. Thirteen handed it back and Thomas took several large drinks; the team had also grabbed some pound cake from the kitchen behind the nurses' station, and Thirteen broke off a hunk for him to eat. Bell took several quick bites and washed them down with more juice. House sat back and took in the scene in front of him.
"So what causes a relatively healthy, though admittedly old guy, to have his pancreas go into overdrive?" The team looked at each other. "Don't hold back just because of who he is, and the fact that I'm the rhino in the room; you need to prove why you got your medical degrees."
"Insulinoma pressing on the beta cells," Taub said.
"Nice try, I already submitted that to the contest down in the ER," House said. "Come on… now's no time to be afraid of the 'Big C.'"
"Cancer?" Bell said with alarm.
"Shhh… they're the ones guessing right now. At this rate, your turn will come soon enough."
"I agree with something Lydia said earlier," Chase said. "It does seem rather odd that right after he goes to one of these pop-up clinics, he has a problem."
"Disdain for them doesn't mean they're truly inadequate," House noted. "Let's focus on test results and not the bug we may have up our butts about these places."
"Radiology will be ready for him in half an hour. We were going to bring him down in a few minutes to get things going a little sooner, hopefully," Thirteen said. Chase had brought the glucose monitor over and did another finger stick.
"What's the magic number this time?" House inquired.
"He's dropped again… sixty three," Chase said shaking his head. "I'd like to bring that number up a bit more and try to keep it there while we do the tests."
"We were lucky to grab the slots we did for all of the tests," Taub pointed out. "Delaying them might create a problem."
"Pack him up a picnic basket," House said. "Let radiology have a hissy fit if they want, but until we get a handle on things, food will be his medicine."
"Greg, if I could have something different to drink… some Coke or Ginger Ale… it might not upset my stomach as much as all of this juice," Bell said. "I'm feeling a bit queasy and I'm sure throwing up would not be good right now."
"Throwing up is never a good idea," Thirteen said.
"Unless we want you to throw up and make you do it ourselves," House said.
"There's a vending machine down at the end of the hall near the other visitors' lounge," said Thirteen. "I'll go get a can." She left the room to retrieve the soda.
"Does anything in particular appeal to you to eat right now, Thomas?" asked Chase. "I've always been of the mind-set that if you eat what appeals to you when you're sick, the more likely it is to stay with you." Bell swallowed another bite of pound cake and shook his head.
"Nothing, I'm afraid. I'm so bloated by all the liquids I've consumed, I feel like a water balloon that's about to burst." House had an idea; he sent out a text to Lydia to see if he was right.
"I'm going to head to the lab to run the blood draw," Taub said holding up a specimen bag. "If anything unusual comes up, I'll text you."
"We'll probably be spending the rest of the day down in radiology," said Chase. "I'll send out a message if we see anything." Taub gave a quick nod and headed out of the room.
"Here we go, Thomas." Thirteen said as she popped a can of Coke open for him. "And here's a straw."
"Thank you, dear; let's hope this does the trick." House's phone began to buzz; he smiled when he saw the text reply from Lydia.
"The other half of the rescue squad will be here in a few minutes," he informed Bell. "The desire to eat will magically return." Bell looked at him skeptically, but he was also sure that his son was right somehow.
"How long will all of these test and things take? Will I have to stay overnight?" House looked almost amused at Bell's question; Chase and Thirteen were concerned to break the news.
"Thomas, it's going to be several days at this point," Chase informed him. "Depending on what the tests show, there's the possibility of surgery and… "
"Days? Surgery? I can't be hanging around here that long! I have to go to the regional convocation at the end of the week… I have a report to give," Bell protested.
"You sure that's all it is? Maybe you have a hot date that you don't want to keep waiting?" House teased. Thomas' face took on a somber, hurt look.
"No. You know I have no interest in that sort of thing. Blythe was the only woman I will ever want or need." House silently berated himself for busting his father's chops. Thomas' devotion to Blythe was not a subject he would ever be frivolous about.
"OK… who put in the order for Frau Krumholz's gingerbread cookies?" Lydia asked as she entered the room. Thomas' demeanor instantly brightened at the mention of the cookies.
"Now, those I will eat!" he said with a broad smile. "What did you do? Run home and make up a batch?"
"No, I did it last night after we got home from the city. I had put some in my lunch today for Greg and me." Lydia handed Thomas a bag which he quickly dove into.
"See the sacrifice I'm making for you?" House asked.
"Believe me, I thank you so very much," replied Thomas with a mouthful of gingerbread cookie.
"So the deal is this," House said. "If you want any more of those cookies or any other baked goods from Fraulein's Goody Shop, stay here for the few days, let us run the tests… " House drew in a breath as he looked away from his father. "And do whatever else is necessary to get you back on your feet." Bell reluctantly nodded his head.
"Radiology is ready for us," Chase announced.
"Time for a tour of the hospital," Lydia said to Bell, trying to sound cheerful. She had picked up on the vibe from House that he was uncomfortable with exactly what this could be. "I just have a little bit more to do on that file I was working on, and I'll come down to see how things are going," she said to House as Thirteen and Chase wheeled Bell into the hallway.
"Do me a favor; stop by Foreman's office and let him know we're heading down." Lydia nodded and took the stairs down from the ICU. Chase and Thirteen had loaded Bell into one of the two elevators on the floor.
"Coming?" Thirteen asked House.
"Too crowded… I'll take the other one," he replied. House watched as the doors closed on the car carrying Bell to the basement of the hospital. He was puzzled; not just by the medical anomalies, but by the fine line he was being forced to walk.
This wasn't just an interesting patient… this was his father. And the further he got into things, the less he liked it.