A/N: Whew, sorry it took so long for this update. My computer was having some issues, and then this site has been having some issues. Days to be able to log on and then days to figure out how to post since it wouldn't accept my word docs. Yuck! Anyway, here's the next installment, please R&R. Thanks!!!
Chapter 23
"I'm impressed, Greg," Dianna said, as House finished another physio session. "You barely whined at all today." She flashed him a grin.
"Just lulling you into a false sense of security," House answered, arming sweat from his forehead.
"I consider myself warned," Dianna responded. "Seriously, in just a month you've nearly doubled the distance you're able to ride in the 50 minutes. It's very impressive. I think next week we'll start the treadmill."
House gave Dianna a dubious look. He wasn't sure he was ready for the treadmill, not with an audience.
"We'll start slow, trust me," Dianna reassured him. "And, why don't you bring your Ipod with you? It will help to have something else to concentrate on."
House only nodded. He'd have the entire weekend to worry about physio. For now, he just wanted to get into the shower and get down to the clinic to get his two hours over with. He felt a hand lightly touch his arm. He looked up at Dianna, who had leaned in close.
"Dr. Wilson bet me $100 I couldn't get you on the treadmill. I'll cut you in, 50/50?" She smirked, and House nodded, grinning. He did love to prove Wilson wrong, and taking his money in the process was just icing on the cake.
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House had been in the clinic nearly two hours, when he walked into Exam Room 2. There was a young man on the exam table, doubled over in pain. The nurse was standing by his head, holding an emesis basin. House rolled his eyes, and closed the door behind him. With luck, this guy would be his last patient of the day.
"Abdominal pain and vomiting," House read from the chart. "Sounds like gastroenteritis to me. When did the pain start?"
"This morning," the man managed to grunt out.
"Uh, huh," House said, now helping the man to lie on his back for an abdominal exam. "And the vomiting?"
"Didn't start till I got here," the man replied, panting. House examined the patient's abdomen, while the nurse took his temperature.
"Temperature is 101," the nurse informed House. He nodded. He pressed on the patient's abdomen, and the man screamed.
"Okay, Mr. Bromley, you probably have appendicitis. I'm going to have a surgeon come down here for a consult," House told the man, who had once again rolled on his side and curled up in pain. House picked up the phone in the exam room. "Need a surgical consult for an appendectomy," he told the nurse who answered the line. "Keep an eye on him until the surgeon gets here," House told the nurse. He stepped out of the room, and left the chart in the folder by the door. He walked to the nurse's station.
"Patient in Exam Room 2 is waiting on a surgical consult for an appendectomy," House informed the nurse at the desk. "Dr. House checking out." House stood at the desk for a few minutes, making a few notes on the charts of the last two patients he'd seen. Normally he would have left them, but it was getting more and more difficult to steal handfuls of lollipops while the nurses were watching. He'd have to wait until her back was turned. House saw the surgical resident go into the exam room with the chart. Just as the desk nurse turned to answer the phone, and House had reached his hand into the large jar on the desk, the surgical resident came out of the exam room, looking annoyed.
"Dr. House," he shouted, and House cringed, caught by the nurse who turned to see what the yelling was about. House took the lollipops anyway, and shoved them in his coat pocket. The surgical resident had now crossed the clinic and shoved the patient's file into House's chest. "The next time you call for a surgical consult, you might want to spend two minutes looking at the history. This guy had his appendix out eight months ago."
"That's impossible," House said, looking at the file now. "He has a classic appendicitis exam," he protested.
"Not without an appendix he doesn't," the resident replied, and walked off. House watched him go, and then looked back at the door to Exam Room 2. "Have not appendicitis guy admitted and transferred upstairs," House told the nurse at the desk, and limped off to page his team.
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"Differential diagnosis, people," House said, looking at his current staff of four fellows. "I say, patient has appendicitis. Medical records say he had his appendix out already."
"You want us to do a differential diagnosis on something that's already been treated?" Chase asked.
"No, but thanks for playing. What else could account for all the physical symptoms of appendicitis along with memory loss?" House asked. He was greeted by silence. "Come on, people, ideas."
"Nothing would account for all of those symptoms. How are you classifying memory loss?" Foreman asked. "Amnesia, selective memories, short term memory? Neurologically, it makes a big difference."
"Guy insists he hasn't had his appendix out," House answered. "I'd classify it as just plain obstinate, but I'm not a neurologist."
"What about porphyria?" Cameron suggested. "Instead of memory loss, he's having delusions?"
"I like it," House said, and wrote porphyria on the whiteboard. "What else?"
"How long ago did he have the appendix out? Maybe the pain is from an infection at the incision site, or from the surgery?" Jasper asked.
"Eight months, too long ago," Cameron answered, looking over the file.
"A surgical instrument, a sponge or something left behind? It could have moved and be causing pain?" Foreman suggested.
"We should get an ultrasound of his abdomen," Chase said. "We could check for gallstones or kidney stones, too. They wouldn't explain the memory loss, but they would account for the rest of his symptoms."
"Jasper, you and Chase can handle the ultrasound. Cameron, I need somebody researching the rest of this guy's history and Foreman, do a neurological exam in case there's something else going on." House watched his team gather their files and leave the room. He sat at the conference room table, and rubbed his leg. It was always sore after physio, but today it hurt worse than usual. He reached absently into the pocket of his jacket before realizing he wouldn't find any Vicodin there. He closed his eyes and rubbed his leg harder.
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Wilson walked into House's office, concerned. He'd eaten lunch alone. That wasn't unusual when House had a case, but it was definitely strange on a Thursday. House was always hungry after physio, but he hadn't shown up in the cafeteria, despite the fact that Wilson had waited for twenty minutes after he'd finished eating. Either it was a really good case, or something was bothering him.
He found House on the balcony, staring at the trees. He was leaning decidedly to his left, and Wilson's concern doubled. His leg must be really bothering him today.
"Light bulbs burn out?" Wilson asked. House looked at him, but said nothing. "Tough case?" Wilson tried again.
"I missed the diagnosis," House said. Wilson nodded. No room for food when you're busy wallowing in self-doubt.
"Appendicitis guy?" Wilson asked. House glanced at him. "I bumped into Cameron. She's worried about you."
"She's always worried about me," House replied.
"Don't," Wilson said. "Don't do that. You can't just shut her off because you're feeling unsure of yourself. Not now. Even Gregory the Great is allowed to make a mistake now and then."
House nodded, and then dropped his head. Wilson knew him too well. That was exactly what he'd been doing. He sent them off to do tests and came out here to loathe himself in private. And he was right about Cameron, too. They never talked about their feelings, but he knew he couldn't just leave her out in the cold anymore.
"Dr. House?" a voice said from his office door, and he and Wilson turned around. It was Jasper, with Chase close behind. "We've got a problem."
House and Wilson came back into the office, and House sat in his chair. His leg was really hurting him today, and he didn't want anyone to notice. Chase and Jasper were setting up a tape for House to see.
"This is the tape of the ultrasound we did," Jasper said, as she pointed to the screen, where the ultrasound images were now playing. "I know I'm a cardiologist and all, but that's an appendix."