"Puppet Master"
Chapter Four-"Reworking the Script"
By: Purpleu
As the elevator doors closed, Wilson pondered the few facts of the case that they had to work with: the boy was apparently a normal child until approximately six weeks after receiving a minor bump on the head. Now… Wilson turned to look at House. He was staring straight ahead at the panel of buttons that operated the elevator, lost in thought.
"House, could the kid have some form of ADHD? It would be an extreme case, granted, but…"
"There are lots of things it could be; the problem is, the symptoms he's displaying don't meet enough of the criteria for the diagnosis of any one thing. And none of it is caused by a bump on the head or PTSD." Wilson chose his next words carefully.
"Are you sure you don't have something of a personal prejudice or interest in this case? Because I'm picking up on something: you are absolutely refusing to consider that the father is right; that the accident either caused the problem or the stress of the incident did." House smirked.
"If that kid has any stress it's from living with an overly critical ass of a father. I know what that's like."
"Which is my point exactly. You just told me not to color my thinking with personal feelings. Or does that apply to everyone but you?" Wilson asked. House was obviously made uneasy by the question. The elevator doors opened as it arrived at the floor housing pediatric ICU.
"Ask me about that later. Right now I hear our patient." Even though Tyler Hunter's room was furthest away from the bank of elevators, crashing sounds could clearly be heard along with the desperate voices of Mr. and Mrs. Hunter.
"Tyler, please sit down on the bed. Look, look; Mommy brought Thomas," Mrs. Hunter said to her son. "Watch, watch; chug-a-chug-a…no, Tyler, NO!" House and Wilson arrived at the door to the room just in time to see Tyler stand up on the bed and throw himself down onto the mattress and then repeat the action again. He was about to jump once more, when his father grabbed him.
"Tyler, you were told no! Now stop this, stop it at once!" his father commanded. House's team just stood back and watched the scene in silence. House saw the way Thirteen was holding her left wrist and took it to mean that she had been a victim of the boy's outburst. He reached over and opened the door as Mrs. Hunter took Tyler from his father and showed him the water bottle she had used to calm him earlier.
"Look, water," she said, tilting the bottle back and forth. "Water." Tyler reached over and took the bottle from his mother. The broad, almost clown-like smile that the boy held on his face even when upset, seemed to increase as he imitated the movements his mother had made with the bottle.
"Has the tyke always been fascinated with water? Or did he become enchanted after watching one too many reruns of Baywatch with Pamela Anderson making us all wish we needed mouth-to-mouth resuscitation?" House turned to Thirteen. "Notice I said all; I included you in that, too." Thirteen squirmed uncomfortably as she saw the Hunters look at her curiously.
"Thanks," she said under her breath.
"No, it didn't start until after the accident. I mean, he always liked his bath and to play in the sprinkler, but," Mrs. Hunter said looking at her son, "never like this." She reached up and stroked his hair. He started to become agitated and moved his hands more rapidly to try and push hers away. Mrs. Hunter quickly stopped touching him and allowed the water bottle to act as his pacifier. Malcolm Hunter turned to House and Wilson.
"Well, I was wondering when I would see you," he said, addressing more House than Wilson.
"We were in our conference room reviewing the files that you sent over about Tyler," Wilson said, hoping the explanation would satisfy Hunter.
"Why, may I ask, are you working on this case? I understood you to be head of oncology. My son does not have cancer," Hunter said, shaking his head.
"He doesn't have PTSD either," said House throwing down the first gauntlet "Looks like you're going to have to sue yourself for malpractice. But first, you'd have to defend yourself against charges of practicing medicine without a license and participating in life without a conscience." House and Hunter locked eyes, their disdain for each other apparent to all in the room. The question was: who would blink first.
"I will take it, that Dr. Cuddy conveyed to you the comments I made to her in our recent meeting; so your reaction to me is understandable. It's not fun dealing with the person intent on finding your Achilles' heel." Hunter glanced at the team and then Wilson. "But I come here as neither friend nor foe. My wife," he hesitated, "…and I would like a re-evaluation of our son's condition." House shook his head.
"So you want us to prove that the basis you used for your BS lawsuit is wrong? That the diagnosis you coerced out of the other doctors and used to ruin a person's life is a lie? Excuse me while I step outside for some fresh air. The three year old bait you're using stinks." Malcolm Hunter allowed a very small smile to cross his face.
"Who slandered me by saying I coerced anything out of anyone?" House wanted to kick himself for allowing Hunter to catch him off guard, but he quickly managed a slight recovery.
"A fly on the wall. At least that's what all the buzz is about," he quipped. Hunter was about to make a comment, when his son began to laugh. Tyler's laughter filled the room not with the joy that a child's laughter usually evoked; this sound had an eerie unnaturalness to it. His arm movements and hand flapping became more intensified and Tyler dropped the water bottle that had been soothing him up till now. He climbed down off of his mother's lap and ran full speed at the glass door to his room. Wilson, however, was in his path and was able to stop him before Tyler crashed into anything or anyone. Rather than become agitated by the restraining touch, he tried to hug Wilson while still flailing about. He quickly moved to other members of the team, exhibiting a very awkward and unsteady gait as he moved about. Foreman, Chase and Thirteen stood frozen in place as Tyler approached each one of them. Taub tried to lean over to talk to the child, but was hit in the face for his efforts.
"Tyler, Tyler come here, baby. Are you hungry? Do you want um-um? Do you want your mushy?" Mrs. Hunter asked.
"Jeanne, for God's sake, talk to him normally. He's never going to learn to talk if you keep that baby babble up," Hunter said disgustedly. Jeanne Hunter had bent down to get her son's attention; she was able to put her arms around him and pick him up.
"He's never going to talk normally. When are you going to acknowledge and accept that?" she asked sharply. House took note of the discord between husband and wife. He wondered if it was the normal reaction to the stress of caring for a sick child or was there a deeper underlying issue involved. "Would I be able to get a small amount of milk, three or four ounces? I need to mix up Tyler's cereal."
"I'll get it," volunteered Thirteen. As she moved toward the door, House stopped her.
"How's the wrist?" She held it out and turned it over to reveal a bruise whose shape clearly indicated teeth marks.
"The skin's not broken; it's OK," she said ruefully. House nodded and she continued out of the room.
"What exactly is Tyler's diet like?" asked Chase. "I take it from what you just indicated he needs to eat soft foods." Mr. Hunter scoffed.
"If you had read his file, you'd know that already."
"The tests and information in the file are basically good for nothing but starting a fire for a wiener roast; they're at least a year old and probably filled with misinformation." House said. He watched as Tyler continued to laugh and bounce off people and objects in the room. "Tell me, who in the family is a surfer dude? Obviously it's neither one of you," noting their dark hair.
"If you mean Tyler's blond hair and blue eyes, there's no one in the family that we could find who had his coloring. We saw pictures going back to our great-grandparents and the only thing we could find was that my maternal grandmother had auburn colored hair," said Mrs. Hunter.
"Doesn't look like he spends much time outside," noted House, observing the child's extremely pale complexion.
"Yes, it was an issue of concern for us for quite some time, but then we just learned to accept that it's one of the things that makes Tyler special," Hunter said.
"In other words, you passed the paternity tests with flying colors." Hunter squared his shoulders and turned toward House, but at that moment, Thirteen came back in the room with the milk Mrs. Hunter requested.
"Here you are, Mrs. Hunter," said Thirteen as she handed the small carton over. "All they had in the kitchen up here was skim milk. I hope that's OK."
"That's fine, thank you. Tyler won't be able to tell the difference." Mrs. Hunter looked away from Thirteen. "I'm sorry he hurt you before." Thirteen shrugged.
"I think I hurt it more getting it out of his grip." She smiled at Mrs. Hunter. "He's very strong." Jeanne Hunter smiled in return.
"It's such a difference from when he was a toddler."
"How so?" asked Taub.
"That's ancient history and not relevant to what's happening now," Malcolm Hunter said. He looked at Taub sharply. "You should be concerning yourself with his present condition and the events that led to it." The lawyer in Hunter was clearly coming out; no unnecessary questions, no unnecessary answers.
"The events that led to his present condition may have well started in ancient history," said House. "It would be negligent to the child's welfare if we ignored anything that could affect his well-being; some would even call it malpractice," House concluded sarcastically, doing his best to imitate Hunter's tone and cadence in speaking.
"Mr. Hunter, I have to say that I agree with Dr. House in this matter," Foreman said. "Tyler's prior medical history could very well hold some clues as to how his current condition came about. It's essential that…" Hunter cut him off.
"My son's current condition," Hunter said looking annoyed as Tyler ran into him for the umpteenth time, "is due to Post-Traumatic Stress Disorder caused by the reckless actions of a group of individuals. I am satisfied with that assessment." He glanced over at his wife. "Mrs. Hunter is not. I'm sure once you examine Tyler you will reach the same conclusions that the other doctors did." He looked at his watch. "I'm due in court." He turned to his wife. "I'll talk to you later."
"Fine," said Jeanne Hunter without looking at her husband; she kept her head down mixing the milk Thirteen gave her with baby cereal. Malcolm Hunter didn't even acknowledge his son as he walked past him to the door.
"I'm just curious," said House as Hunter put his hand on the door handle, "how it is you think that we'll reach the same incorrect opinion as the other doctors did. It doesn't seem terribly likely since you don't have pending lawsuits against any of us the way you did against three of the four doctors who were treating your son when the medical reports you brought in were written. The reports," noted House, "that you submitted as evidence in your various lawsuits relating to your terribly traumatic car accident." He and Hunter stood inches away from each other, eyes blazing with contempt; Wilson was sure that if there weren't any witness, Hunter would have thrown a punch.
"Dr. House, what I said to Dr. Cuddy was just an off the cuff remark. If I choose to, I can easily make it a reality." With that, Hunter turned and slid open the door to the room. As he stepped out into the hallway, he almost collided with Jeffery Davidson, the board member who first approached the team with Tyler Hunter's case. The two men stopped, exchanged curt greetings, and then Hunter hurried on his way.
"Hello," Davidson said nodding to everyone in the room, "I wanted to see how things were going…" He reacted to Tyler's running into him with a slight wince as the boy hit him in the small of his back.
"Tyler," Called Jeanne as she rose from her chair, "look what Mommy's got. Mushies." She offered him a spoonful of cereal by placing it directly in his mouth. The food must have appealed to the child because as Mrs. Hunter backed up to sit down again, Tyler followed her as she held out another spoonful of cereal. She breathed an audible sigh of relief as he began to slowly maneuver himself onto her lap to eat the food. "To answer your questions from before: yes, Tyler eats mainly soft foods. We were told he was born with extremely low muscle tone in his mouth; his whole body actually. Although he had over tonality in his calves as a baby and into being a toddler. He didn't walk until he was fifteen months old and that was after physical therapy. He's also had speech therapy." The team looked at each other in shock.
"Mrs. Hunter, are you aware of the fact that none of that information is in the file that was sent from St. James Hospital?" asked Chase.
"That file wasn't sent to you by the hospital; I brought it over," said Davidson. House looked at Jeanne and then Davidson.
"So, whose point man are you; his?" he said nodding in the direction of the door, "Or hers?" Davidson looked at Jeanne.
"I'm hers; but for personal and professional reasons, I have to walk a very delicate line. I'm Malcolm Hunter's lead accountant."
"So he has both you and his wife on the board, both bringing back lots of good gossip of cases gone wrong," said House. "It's even better than insider trading."
"No!" Jeanne said quickly, "No; I mean, yes, I've told him about things going on here at the hospital, but never with the intention of allowing him to maliciously go after anyone. Dr. House, I have to apologize to you especially; when I mentioned your name to Malcolm as someone who could help Tyler, I had no idea about the threat he made against you. I only found out when Jeff told me." Everyone on House's team and Wilson began to speak at once.
"What threat?"
"When did this happen?"
"Why didn't you tell anyone?"
"YO!" House yelled out. "Do you want an answer or would you rather just stand there and babble like a bunch of Ashton Kutcher groupies who just found put he's back on the market?" Everyone in the room quickly quieted down. Only Wilson dared to speak.
"House…" he began. House shot him a look. Wilson took a deep breath.
"House I…" he said more quickly than before. House shot him another look. Wilson rolled his eyes, gave up and put his head down.
"Why don't you tell them?" said House to Davidson. Wilson picked his head up and just stared at House as Davidson began to speak.
"A few months ago Malcolm and I were here to discuss a settlement on a suit he brought against the hospital and some of its staff. Dr. Cuddy was seeing us out when Dr. House walked by and made some remark to Dr. Cuddy."
"An entirely inappropriate one, I'm sure," said Wilson. Davidson smiled.
"Well, after Dr. House walked away, Malcolm turned to Dr. Cuddy and said that he was surprised that he had never had to handle a case against Dr. House before and that if he ever did, he would make sure he would win and win big," said Davidson.
"I believe more precisely, he said I'd wind up living in a cardboard box by the side of the freeway, because he'd make sure I was never allowed to practice medicine again." There was a stunned silence. Finally, Thirteen spoke.
"What the hell did you do to piss him off so?" she asked.
"Yeah, it had to have been a doozy," Taub said. House looked at them in disbelief.
"Way to go, kick a guy when he's down."
"Why not?" said Chase. "You do it all the time."
"You're his Irene Adler," said Wilson turning to look at House. "He hasn't figured out how to get to you or beat you and now, he's willing to use his own child to try and get to you." House looked at Wilson and nodded his head.
"I see you've read the book I loaned you."
"But if we agree with the doctors at St. James and say it's PTSD, then how can he go after any of us?" asked Chase.
"Don't flatter yourself; it's not you he wants. It's me. By the fact that Diagnostics is handling the case, I'm automatically put in the firing line," said House as he began to pace the room. He noticed Thirteen gesturing to him.
"What's that, Lassie? Timmy fell down a well where his cell phone can't get reception?" House said. Thirteen rolled her eyes.
"Look at Tyler and his mom," she said. Jeanne Hunter and Tyler were both asleep, the wide, unnatural smile gone from his face; a look of peaceful contentment in its place. She had put the bowl of cereal on the table next to her and was cradling her son in her arms.
"So he does have an off switch," noted House. Tyler squirmed slightly at the sound of House's voice. Wilson gestured for everyone to step out of the room. After all had exited, he closed the door and took a deep breath. House started to pace a few steps back and forth, staring at the floor as he did.
"Please don't just dismiss this by agreeing with the diagnosis Malcolm made them put in that report." It was Jeffery Davidson speaking as watched Jeanne and Tyler sleep. He never took his eyes off them as he continued. "Tyler doesn't sleep through the night or take any kind of prolonged naps. They've been through countless nannies and aides. Every one of them has left because the boy is such a handful." He turned to face the group in the hallway with him. "Jeanne needs help desperately. Malcolm won't even deal with Tyler except to put on a show of poor, pitiful him having a kid that will never be the starting quarterback at Stamford." He turned back to look at mother and son; this was a different man than the one who had cornered Foreman and Wilson earlier that day. "She's been through so much of this alone. I want to do what I can to make sure she doesn't have to do that anymore." Wilson glanced over at House; he didn't change his expression dramatically, but Wilson could see an understanding in House's eyes.
"How long has it been?" House asked. Davidson looked over and realized that House caught on to the nature of his relationship with Jeanne.
"Two years. I've worked for Malcolm for four, but Jeanne and I didn't start seeing each other until Malcolm completely abandoned her, emotionally and physically. Being a judge's daughter, she was nothing more than a trophy wife to him."
"So, he has own action going on the side?" House turned to look at Wilson. "Between you being a three time loser and heartwarming little scenarios like this, you wonder why I don't believe in marriage."
"Have you told Lydia that?" asked Thirteen. House turned to scowl at her.
"So, you knew Tyler before the accident," said Foreman. Davidson nodded.
"He was a delightful little boy. He had the speech and movement issues that Jeanne described to you, but nothing resembling the way he is now. If I didn't know better, I would think that the accident did have something to do with this; but I know that's not the case."
"How so?" Foreman asked.
"He began to show some signs of additional problems in the couple of months before the accident. He was never very talkative, but it got to the point where he would never speak unless spoken to, never looked at you. He would go through fits of hyper-activity, running around; and then just drift off into his own little world."
"His mother never noticed this?" Chase asked.
"She did and she told me later on that she mentioned it to both the speech and physical therapists, but they didn't seem too concerned about it. They never did give her a reason for the low muscle tone issues." House had been leaning against the wall thinking and taking in what Davidson was saying. He stared at the floor as he rapped his cane on it.
"House," said Wilson, "where do we start?"
"We are going to need to get a fresh set of tests. Not only are they over a year old, but their validity is clearly in question. Metabolic blood panel, CBC with differential, thyroid panel including TSH and uptake, urinalysis, EKG, EEG. See where those results take us, we'll figure out how best to use an MRI." He looked at Davidson. "We're going to have to give the kid something to sedate him in order to get these tests done. Think the mom will have any issues with that?"
"No; unfortunately, she's used to it. Oh, and I know there's no urgency in terms of the fact that what's wrong with Tyler isn't life threatening, but according to Malcolm, he's set a time limit. If you haven't come up with an answer by Friday morning, he's taking him out of the hospital and using your failure as ammunition against you." House looked away from the group.
"In other words, I'm fighting two battles: the kid's and my own."
"I'm afraid so," said Davidson. "I'll do whatever I can; give you whatever information you need to help Jeanne and to protect yourself from Malcolm. I took this job four years ago because it was necessary at the time. Let's just say, it isn't any more." House nodded and looked at the team.
"Send the kid into la-la land and get the tests started. You," he said addressing Davidson, "stay here and keep mom calm for as long as you can."
"I've got at least two hours before I have to be back at the office. That should be when Malcolm comes back in from court. Is there any way for Jeanne to sleep in Tyler's room in something more comfortable than just a regular chair?"
"He'll be sedated and won't know she's gone," said Thirteen. "She really should go home and get a decent night's rest." Davidson shook his head.
"Home is the last place she should go to get rest."
"We can arrange for a reclining chair to be brought in," said Taub. "It's not very well padded, but it's better than nothing."
"Thank you." Davidson walked back over to the door to Tyler's room, very quietly slid it open and walked inside. House looked down the hallway in the direction of the elevators.
"As soon as you have results, bring them to the conference room. Grab something to eat on the way; it's going to be a long haul." House started to walk down the hall at a slower pace than usual. He wasn't sure if it was because his leg was hurting even more than before or if it was the weight of the idea of finally having to confront Malcolm Hunter head on. He and Hunter sparred a bit several years back with a series of letters to the editor in a medical journal. Cuddy stepped in and "forbade" him to write any more replies; of course he continued under a series of phony names. That was fun. This was anything but.
"House!" Wilson called out. He walked quickly to catch up to House who was nearing the elevators. "Foreman suggested I go with you to brainstorm. They've got everything covered as far as running the tests." House stopped and looked at Wilson.
"You told Foreman you wanted to babysit me. You're afraid I'm going to have some sort of melt down."
"No, but I do think you could use some company. Why didn't you tell me about the conversation between Cuddy and Hunter?" House shrugged and continued toward the elevators.
"Cuddy seemed to think he was just blowing off steam. He was pissed because he didn't get the full settlement he wanted from a case. He forgot that with a good compromise, every one walks away mad." He pressed the call button for the elevator.
"I was going to go grab some iced tea and maybe some chips or something to munch on while we work. Are you hungry?" asked Wilson.
"No."
"When was the last time you ate?" House smiled a little. The elevators opened and the two stepped inside. Wilson pressed the button for the lobby.
"Lydia made eggs and toast this morning. Actually, she sent me a text while ago," he said as he took his cell phone out of his pocket. House called up the text. As he read, Wilson could see the expression on his face become more relaxed.
"She got a call for a second interview at the school she went to yesterday and a private school she sent a resume to a month ago called her to come in. At least someone is having a good day." The elevator doors opened and the two walked out into the lobby. Wilson stopped just outside the cafeteria.
"Look, I'm going to go grab a couple of iced teas and a couple of orders of fries and I'll bring them up to the conference room. Why don't you go give her a call? You know you'll feel better when you hear her voice." House gave Wilson a look.
"God, you make me sound like such a wimpy pile of gruel when you say things like that." Wilson smiled.
"You know it's true." House turned and started to walk toward the door; he figured some fresh air would be good for him. "Hey, House?" He turned to look at Wilson. "I'm not sure how much help I'm really going to be on this case. It's going to be more like I'm just riding along on your coattails." House glanced over at him.
"You'll do what you always do: play Watson to my Holmes; play Martin to my Lewis; play Beavis to my Butt-Head…"
"OK," Wilson said throwing his hands up, "I get the idea."
"Wilson, do we have any more white boards in this place?"
"You mean other than the one in your conference room?"
"Yeah." He could see House was deep in thought.
"Sure, we've got a couple of them."
"Good," said House. "Send one up to my conference room." Wilson looked at him quizzically. "We're going to need more than one to figure this case out." House turned and stepped outside to call Lydia.