Chapter 6

"The Session in Dick's Office"

Dickinson looked up to see if Wilson knew the recorder was running.

Wilson nodded. He did.

Dick began:

"Monday, May 22.

Richard Dickinson, Dr. James Wilson … case file GAH-61159-W-228 …

"James …You are concerned about your patient, Gregory House: How do you feel about what has occurred?"

Across from him, Wilson squirmed in the chair. His blue jeans made rustling sounds on the upholstery, which would be audible on the sensitive recording later on. Dick let it go. Wilson's eyes circled the room and came back to rest on the little recorder in the center of the desktop. "Why does that matter?"

"It matters," Dickinson stressed, "because I don't think you'd be here if it hadn't affected you in some significant way."

Jimmy met his gaze for an instant and then flitted his eyes quickly to the side. Already he was nervous, afraid of breaking a confidence, of giving too much of himself away too soon. "The way it affected me isn't important. What I did to House … that's what's important, that's why I'm here."

"Okay," Dick continued gently, "then tell me what you did to Dr. House."

James swallowed. His brow furrowed. He was already beginning to regret this line of questioning. "I didn't … I allowed … I … I betrayed his trust. I let my own fear of his physical pain control how I reacted to it … to him. It was easier to fall back on prevailing medical beliefs … wrong beliefs … than it was to watch him hurt. So I convinced myself that he didn't hurt … that he was just … an addict. If the pain wasn't real, then I didn't need to worry about him, to hurt for him.

"If I … if I'd allowed myself to believe that his pain was real, it would've … I pulled back. I did what I had to do to protect myself. And he … he suffered for it …"

Dick watched his friend with compassion, wondering what was going on here. He'd stuffed a stick pen between two of the atrophied fingers of his right hand and grasped it tightly with the thumb. He was taking notes furiously in a spiral notebook that lay on the desk before him. He needed something concrete to refer to, not just voice tones on a small recorder.

"And not wanting to watch someone we care about suffer is a natural reaction."

"But I'm not just his friend, I'm a doctor; I should have helped him. I didn't." Wilson's voice was shaking. His deeply felt self-recrimination was working hard on him.

Dickinson looked up from his writing. "Yes." He said. "You did!"

Wilson's eyes were beseeching. "You don't get it! I watched him suffer for months before I did anything. I watched him, and I was angry with him, and I pitied him. I thought he was weak, and I convinced myself I was helpinghim by denying him pain relief. All I did was … I'm the … I'm responsible for his turning to morphine, for the breakthrough pain getting so out of hand that we had to …"

Dickinson hitched a surprised breath.

Morphine? The man shot himself up with morphine?

Wilson looked ready to weep. My God! What a burden he was carrying!

"Let me get you some water. This is hard; take your time." He dropped the pen and the tablet and went to an insulated pitcher beside the coffee urn. Poured a small glass of ice water and carried it across. Handed it wordlessly to Wilson and then resumed his seat. All the chinks and clanks of non-vocal physical activity were spiking the electronic tracking of the recorder. The red light on the dial was blinking furiously, as though searching for voices where there were none. Dick stared at it with quiet amusement.

"Thanks. That's … better. I'm okay. Sorry. I didn't mean … this isn't supposed to be about me."

Dick disregarded the unconscious bid for sympathy and went on gently. Wilson's sense of guilt was weighing heavily on his shoulders. "Why did you decide to help him? When did you begin to believe the pain was real?"

"It was Friday. House is … well, he likes to complain, and he even makes a show of taking the Vicodin, and he's been known to … (soft laughter) umm … well, actually, to terrorize people with that cane. (more subdued laughter). But one thing he never allows himself to do is show his discomfort to others. Even with me, he'll gripe, he'll get dramatic. But I've rarely seen evidence that the pain was real.

"Twice. Maybe three times in the last six months … and he didn't have a choice. But Friday he collapsed in front of his team. Dick, no exaggeration, House'd rather die than show physical weakness in front of those kids!

"So, when they paged me, and I found him on the floor of his office, with the three of them there … I knew. I … just knew, then. Couldn't deny it anymore; didn't even try. I gave him that first dose of morphine without even questioning the necessity. His need was just so clear …"

Wilson's eyes were red now, and Dick could see him beginning to lose it. "May I have some more water?"

Dickinson nodded. "Of course." He hurried to comply. Handed it across and watched as Jimmy gulped it greedily in the effort to control his runaway emotions. Dick needed to keep the man talking. "So … Friday was the first time that the validity of his pain wasn't in question? The severity of it, I mean."

Wilson nodded. He leaned across to place his coffee cup, still half full, on the desk, then shifted back and finished the rest of the water. "Yes … uh, no. There were … two other incidents."

Dick saw the pain that filled the other man's dark eyes, so he leaned back quietly for the thirty seconds it took for Wilson to gather himself and resume speaking.

"I was at his apartment one evening a couple of months ago. He'd been at the piano for quite awhile. I was getting ready to leave, and he stood up and his leg began to spasm. I thought at first that … it wasn't real; I'd refused to refill his Vicodin prescription earlier. The refill would have been only three days early, but … I thought … well, I was trying, I guess, to establish some … boundaries … on the whole narcotics thing, and …"

This time, Wilson's silence stretched out so long that Dick was beginning to become concerned.

This man, House, is a musician as well as a colleague? They were at House's apartment? Doctor? Best friend? There's something deeper emerging here …

Quietly, Dick urged Wilson: "Go on …"

"Then I saw his eyes, and I knew the pain was real. I went to him and tried to get him to sit. He was angry, and he was scared, I think …

"Finally I had to force him to sit down. I checked his pulse and it was over 100, which confirmed medically that the pain was real. He would have told me to leave at that point, if he'd been able to. I know that. But I knew he was in far too much pain to make any sort of protest, so I took advantage of that to help him. I massaged the leg until the spasm relaxed. He'd never have allowed that if he'd been in any shape to stop me.

"It … hurt, to know that he was suffering that much, and that I'd initially thought he'd been trying to trick me."

Another long silence stretched out. Dickinson was ready to pause the recording while Wilson gathered himself, but Jimmy looked up into his face with agony in his eyes.

Dick withdrew his hand. "You felt guilty." It was a statement, not a question.

"Yeah … and sorry too." Wilson pulled himself together and expelled his breath with a whoosh that billowed his cheeks. "But I couldn't make myself say that to him. So after the spasm ended, I sat there that night and watched him while he slept. I wanted him to know I cared. But I couldn't say those words either. And every time he moaned during the night, it got a little harder for me to deny that he'd really been suffering. But instead of trying to discuss it with him, figure out how I could really help, I … just wrote out the scrip …

"And we never spoke of what had happened."

Dick raised his eyebrows. Wilson was shoring up, willing to continue. He took full advantage of the opportunity.

"And the second incident?"

Jimmy was beginning to look bleak again. "It was … even worse …" His voice broke like a piece of tinder wood on the last word. The red light on the recorder spiked brightly.

Dick took a deep breath and paused a moment. This second incident, pulled suddenly from the depths of Wilson's suppressed memories, was threatening to overwhelm his old friend far beyond the difficult events they'd talked about up to now.

"James, I'm sorry … but I could really use a break here … and some coffee." He snapped off the little recorder and smiled encouragingly. "You're doing fine. I'm becoming aware that this is difficult beyond measure for you. How about it we have another coffee and check with Margie to see if there's any food being delivered to our doorstep …"

Wilson nodded. "Yeah. Let's just talk about something else awhile … if you have the time. I didn't realize what those memories were going to do to me … and yeah … I'm really starting to get hungry."

Dick pressed the intercom on his office phone and the woman in the outer office answered immediately. "What's up, Boss?"

"We're hungry, Marge!" Dick said sternly, then grinned and answered Wilson's question.

"Of course I have the time! For you, Jimmy Wilson, I'd make the time anyway. This case is far too important to be ignored any longer, and it's not helping you to repress it."

Margie's voice came back on the intercom while he was still speaking. "You gentlemen up for a big pan of lasagna? Side salad? Cherry pie? Dais is out here with your lunch!"

Wilson looked up, suddenly smiling. "Ardais!" He said. "Ardais cooked for us?"

"Yes he did," Dick said. "I told him you were coming here, and he wanted to see you." They both rose as the door to the outer office opened wide.

Poised in the entrance stood a tall, dark, curly haired man with large teeth filling up an equally large smile. He was in brown slacks, blue shirt with rolled-up sleeves and a fancy flowered apron tied neatly about his slender waist. Ardais Verengi-Degas' huge eyes were sparkling with intelligence and humor. In spite of himself, James Wilson could feel himself grinning, hurrying forward to take the large tray of food from the man's hands to set it on the desk.

The men embraced fondly while Dick Dickinson perched a hip on the desktop and smiled at Jimmy's surprise and delight. Ardais pulled back from the bear hug and surveyed Wilson's light blue shirt, also rolled to the elbows, his blue jeans and deck shoes with no socks. "Still got that 'preppy' thing going for you, eh, Jimmy?" Ardais said teasingly.

Wilson looked down at himself and pursed his lips. "Old habits die hard, Dais!"

"I can see that."

They spent a half hour over the delicious meal, catching up with each other and talking about college days and shared dormitory nights cracking the books and swilling beer and chomping beer pretzels and Slim Jims.

When Ardais left awhile later, Wilson had begun to feel almost human again, renewed by the comfortable old friendship and a little jealous of the loving rapport so easily shared by the two longtime partners.

When the session picked up again and Dick's thumb pressed the "record" button, the world changed back to the stark reality of Gregory House's pain-filled world, and Wilson's urgent attempt to fit himself into it with him.

Dick Dickinson began again in his no-nonsense fashion.

"Okay … when we paused, Jimmy, you were going to tell me about the second time you questioned your own belief that Dr. House was … uh … exaggerating his pain."

Wilson cringed in remembrance. "I … this is hard. Do we have to discuss this one?"

Dick stared at him, and Wilson was surprised at his reply. "No; of course we don't. But you brought it up, and it's bothering you. It might help to …"

"You're right," Wilson admitted. "It's … yeah, it's important. I … it's just … I'm uh … ashamed that this happened, I guess.

"It was just last month, and I'd stayed late at the hospital. Didn't know that House was still there too. I was leaving, walking past his office, and a movement caught my eye.

"He'd drawn the blinds, but they weren't completely closed, and he had his back to me, so he didn't know I was there, and … he'd put his cane down, and was trying to walk without it, and he … fell … twice. The second time, he just stayed down.

"And he leaned his head against the edge of the chair, and he was … crying. He might have seen me then, but he was so consumed by his pain, I don't think he was aware of his surroundings.

"And … I … walked away. Just pretended it never happened. Called him later, and he sounded okay.

"I was able to forget what I'd seen … until Friday. When I got the page about his collapse … as I was running to his office, that scene just kept replaying itself, in my mind. And now I see it as another missed opportunity to prevent what happened Friday."

Dickinson's voice was soft. He could feel Jimmy's hurt deep within his own gut. God! No wonder the man was screwed up about this …

"And you can't let it go."

"I don't want to let it go! I want to remember what my denial did to my best friend, to the man I think of as my brother. And now, he's just getting to the point of being able to trust me again, and maybe even to trust a friend of ours … our boss.

"But this morning he just missed hypovolemic shock. And I mean by minutes. Know why? He didn't want me to know he's been nauseated; he was afraid I'd cut the dose on his pain meds, was afraid I'd insist on an anti-emetic.

"He's trying, I really think he is, but he's not there yet. We need to figure out a way to get 'im there, fast, before his distrust kills him!"

Dick frowned. "Would he be willing to come in and see me?"

Sardonic laughter from Wilson made him rethink quickly. "I'll take that as a 'hell no!'"

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

"Then this is what I'd suggest." Dick was beginning to sense the cold, hard facts about Wilson's stubborn patient, and about the real reason Wilson had traveled all the way to Pennsylvania from central New Jersey.

"Based on what you've told me, no one else is gonna be able to help him. 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. And the unusual thing about this situation, Jimmy boy, is that you're uniquely qualified. Even 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 isn't a problem. And you have the added benefit of being able to see his physical issues as well."

Wilson sighed deeply, half afraid Dick wasn't seeing the point. "But that's part of the problem … a huge part. I told you what happened this morning; he could have died, simply because he couldn't bring himself to trust me. So now I'm gonna be his surrogate shrink? That oughta tear it for sure!"

"James!" Dickinson admonished. "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 toward 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 gotta also 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 stared at Dickinson for long moments before he realized his mouth was hanging open. He began to understand fully, for the first time, and he felt a rush of compassion for House. He also felt a small lift from his burdened shoulders, of the guilt he'd been carrying for so long.

House could not accept help. Nothing Wilson had already tried to do could have been done any better, or with any more love. The results would have been the same. Wilson finally understood that House's behavior wasn't controlled by House … but by an unconscious denial of his own circumstances.

Dickinson was staring at his friend with a kindly understanding that Wilson found hard to accept. "Don't forget what we all learned in Psych 101 … tragedy tends to bring out the best and the worst characteristics in people. When the tragedy becomes chronic, those characteristics are magnified over time.

"So, if House has always been loathe to rely on others, now it becomes an overriding force in his life, in his attitude toward both his illness and toward the people who want to help him.

"He's literally programmed to fight you!"

The newfound feeling of compassion toward House was threatening to overwhelm Wilson. He looked up at Dick with the beginnings of hope on his handsome face. "So he's not responsible for his behavior?"

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

Wilson sat still, silent and lost in his own thoughts for a moment:

So Cuddy's spot-on with her assessment of House's personality. "Nanny 911" isn't too far from the truth! Viewing that big jerk as a child will make it easier to be patient though. Not just to 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?" Dick asked, quickly breaking Wilson's bubble of retrospect. "Somebody who can share this … burden … with you? It's gonna get pretty rough …"

Wilson knew the answer, but he gave it long thought before he replied. "Lisa Cuddy … our boss, Dean of Medicine 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 past 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." Wilson wished House's Dad had not pushed his son's perfectionism and the attendant depression. But that was a long time ago.

And Stacy. He had loved her, and then blamed her for everything that happened to him the last six years. Wilson had to admit, sadly, that the only people House could really count on were Cuddy and himself.

"So you're not going to try this single-handedly? This Dr. Cuddy will support you?"

Wilson didn't hesitate. "She will! Every step of the way!"

Dick thought for a moment. "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 you go out and buy yourself a punching bag!" There was a twinkle in his eye and in his voice as he said it.

At Wilson's small laugh, he continued. "I'm not joking, Jimmy! 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. You'll need an outlet … I mean it!"

"I can handle it, Dick. It's a relief to know that he's not just the selfish bastard the rest of the world sees. I know the man I described to you sounds … sad and sick, not anybody you'd 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.

"I can't explain it. You'd have to meet him and look past the walls he puts up. Then you'd see why he's really worth it. When he let me 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 …"

Listening closely as Wilson continued, Dickinson began to perceive … something … deep in Jimmy's eyes when he talked about Gregory House …

"That's another thing we need to talk about, Jim … the loss of that extra pain. It's going to be part of the problem, believe it or not. You've said he's integrated the pain into a big part of his personality, his behavior. That means 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 or so, but it could be a very nasty time."

Wilson shifted in the chair nervously, and stared hard at the chaise lounge across the room. He hadn't considered that getting rid of the breakthrough pain cycles could have any sort of negative impact at all. "How can I help him through that?"

"I think you're already doing that by instinct," Dick said. Just be there for him! Let him lash out at you if he needs to! That'll be his way of working through his own confusion. The 'attacks' on you aren't really attacks; I think what he's really 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. It'll only become a problem if he denies, to himself, that things have changed."

Jim Wilson took a deep, deep breath. He looked across at his friend and noticed that Dick was looking at him with an amused and mysterious expression of sympathetic understanding on his face. Wilson frowned for a moment, wondering what the look might mean. Whatever it was, it was making the hackles at the back of his neck stand up like the toilet seats in the physicians' locker room. He decided to ignore it for now, and maybe think about it on the drive back to New Jersey.

That … and a few dozen other things!

"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."

Dick waited patiently, fully knowing, just like House, that the biggest concern tended to pop up at the end of the appointment.

Okay … sorry, House … gotta do this, buddy … but I'm not gonna lose you now!

"I think that House may have a suicide plan." Wilson looked directly at Dick, and the psychologist could see the racing of emotions, the fear and the desperate plea for reassurance in the dark eyes.

"That doesn't surprise me in the least," he replied gently. At the surprise on Wilson's face, he continued. "In my experience, at least half of all chronic pain sufferers have a plan. And that plan is often the very thing that prevents them from becoming acutely suicidal.

"Just knowing 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 somebody who's less organized, more impulsive."

Wilson allowed himself a relieved sigh that came from deep within his soul. "I was so … worried …"

"Understandable. And I'm not saying you shouldn'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. It sounds like that's what'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 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 … and he may become more willing to be truthful with you."

Wilson blinked at the thought. "That would be interesting," he said with a smile. He shifted in the chair again and prepared to stand up.

"I think I've taken up enough of your time, Dick. I'm anxious to get back and see if House and Cuddy have killed each other yet."

They both smiled at the thought, and Wilson cocked his head as another idea suddenly occurred. "Let me ask you something … do you still play such a mean game of poker?"

Dickinson grinned in reply. "Oh yeah! I 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, and let me slip your name into a few conversations with him. And then you're invited to a poker game you'll never forget. You and Ardais. If I remember correctly, he's a pretty sharp cookie with a handful of cards too."

Wonder what nicknames House'll christen these two with???

"Sounds good, Jimmy. I'm looking forward to meeting Dr. House, Dr. Cuddy too, maybe. And it was really great getting to see you again … even if the circumstances were less than stellar. With a little luck, things should improve greatly now."

Dick pried a business card from a stack on his desk and handed it across to Wilson. "Our home number is on there … and you can call anytime if things get a little too rough. Questions … problems … or if you just need to vent. Okay?"

James took the card, studied it, and then put it in his shirt pocket. "Thanks, Dick. I can't tell you how much I appreciated this." He reached out with his left hand and Dickinson hesitated only a moment before reaching out with his own left, and grasped Jim's in a clasp of comradeship.

"One more question, Jim … what are you getting out of this?"

Wilson looked puzzled for a moment. "Well, I hope House will be able to acc …"

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

Wilson blinked. Dick had caught him waffling again. "This time," he said quietly, "I don't have to lose a brother …"

And this time the Demons won't win!

Wilson left the beautiful old office building and headed to his car. He felt as though the weight of the world had been lifted from his shoulders. At the same time, and in a more abstract manner, Dick's attitude and questioning demeanor as he'd asked some of his penetrating questions, came back to haunt Wilson greatly. A few times the expression on his old friend's face had seemed almost pitying, and it was disturbing in a puzzling way.

What wasn't he getting?

Oooo0oooO

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