"Life and Limb"
Chapter Ten - "Life is Just What you Make It"
By: Purpleu
"Why can't some people learn their manners and wait their turn?" House said disgustedly. Granted after the MRI was done on Wilson, and everything was hopefully good, House could turn more of his attention to the mystery bacteria that this firefighter picked up. He felt a special need to get an answer for the case, since one of his specialties was infectious diseases; he did not agree with the concept that even he got stumped once in a while. Lurking in the background still was his mother slowly dying and the issue of his leg. Right now, his leg was killing him, a combination of overuse and missing his nighttime dose of medicine. He'd have Lydia bring his pill case over to the hospital since he intended on camping out there for the next several days until Wilson was literally back on his feet. As far as his mother…she was a strong woman, she had to be to suffer through the abuse John House put upon her. House just hoped she had the strength to hang on until he cleared things up around the hospital; if not to get answers, but to say he was sorry for thinking the worst of her all these years.
"House I can see the wheels turning," Foreman said. "Where are you going with this?"
"It depends on where he's gone," House replied. He looked at Lydia. "How far did you get when you played twenty questions with him?"
"I looked over the information sheet he filled out, asked him what brought him in, although from looking at the leg, it was very obvious. Inquired if he was allergic to any medication, to which he said no. Asked him if he had traveled out of the country or had been near anyone who was ill; the answers to both of those were no. He said that the poison ivy happened approximately a month ago, and that he unfortunately had 'busy fingers' as he put it; scratched at the one area on the left calf constantly. He said the wound never did close up." House thought for moment.
"That's as far as you got." Lydia nodded.
"I took his temperature, which was not particularly high, 100.3. He said it had been bouncing up and down for the past few days. I was about to take his blood pressure when he seized." House turned his attention to his team.
"Who took the medical history?"
"Thirteen and I did," Taub replied. "We got the information from his wife; he was unconscious the whole time."
"He hasn't really fully awakened," Thirteen said. "His responses were very mumbled, weak; so we concentrated on questioning his wife. But, nothing remarkable other than the poison ivy incident."
"And the aches and pains he's had since he fell off a ladder at one of his calls," Lydia noted. House tried to remain calm.
"When were you going to share this little tidbit with the rest of the class?" he asked twirling his cane as he spoke. Lydia knew she was not in the same league as any of House's team members, but she did know how to take proper notes; it all depended on whether someone bothered to read them.
"I wrote it down along with my other notes on the patient on the information sheet he filled out; I've always understood that to be proper procedure," Lydia said in an even tone. House shot her a quick look and then addressed Thirteen.
"Let me see the chart." Thirteen handed the binder to House and glanced at Taub and Chase. The three of them were clearly uncomfortable.
"Umm…I think I should move along," Detective Williams said. Just about everyone turned and looked at him with surprise; they had forgotten that he was in the room. "If I hear anything about your necklace, I'll contact you," he said to Lydia.
"Thank you, I appreciate that," she replied. With a quick glance backward at the group, Detective Williams left the room.
"Wow," House said with a distinct lack of enthusiasm. "Here it is, right on the information sheet like all clinic notes usually are: 'patient fell from ladder approximately six weeks ago, complained of aches and pains since then; x-ray revealed no broken bones. Primary MD said patient should see a PT if pain continues.'"
"House, you're always the first one to say how useless the clinic, and even E.R. notes can be…" Chase began.
"And I also always say that they should be given a cursory glance in case there's a diamond buried in the pig poop. Confirm with the wife whether he's been to see a PT or not. If he has, find out what if any meds he's been given. If she says he hasn't been to a PT, we need to find out how he's been dealing with the pain."
"His tox screen was clean," Chase pointed out.
"And we all know that tox screens only care about the fun stuff; there are plenty of other pain pills, less fun but more deadly…like ibuprofen," House said giving Chase a hard stare. House looked at Lydia and Taub. "You two still going over to the patient's house later?"
"I have the keys right here," Lydia said holding up a key ring with a bright piece of metal hanging from it. She looked up at the clock. "We'll have to do it either before twelve or after three; that's when the kids will be here. As much as Ben would love to go and see how invading a person's home relates to medicine, I think it would compromise things if I brought either one of the kids along." House kept a blank expression on his face, but he was pleased at the way Lydia was handling the situation. Her kids were important to her, but in this scenario, it was best if they stayed in the background.
"Lydia, you go do what you have to," Annie said. "If Marianne comes by with the kids before you get back, I'll let them visit with James for a little bit and then we can go to the cafeteria, maybe the gift shop…now that I have my pocketbook back I can take care of things."
"You know, your children were very good with us when they visited last night," Mrs. Wilson said. "They were very polite, and they listened when we told them to do or not to do something. As long as one of us is with James so he knows we're still here, I think everything will be fine."
"Thank you, Mrs. Wilson; that's very kind of you," said Lydia with a smile.
"Don't be silly," Mr. Wilson said. "We…we don't get to spend any time with our two grandkids due to some…unfortunate and sad circumstances. But that doesn't mean we're lacking in the grandparent gene." He took a sip of his coffee. "Just say the word when you're ready to go pick up the cars."
"I'll be ready in just a minute; I want to grab a quick bite to eat." Lydia refreshed her coffee and looked over the morning pastries. House took a deep breath; he decided he might as well give in to the empty feeling in his stomach.
"Hey, Fraulein; grab a bagel for me."
"Sure, plain or…"
"Salt if they have it. I'll treat it like a pretzel." House looked at the notes in the patient's chart which still sat on his lap. He closed the book and handed it to Thirteen.
"I'll meet you down at the lab. I want to look at a slide of the culture, see what we have. Re-do his labs while you're there. If gangrene is starting to set in, his white cell count should be much higher than this. Someone or something is lying and we need to figure out what. Piggy-back on doxycycline to the cephalosporin; infuse it at the same rate." Thirteen nodded and left the room silently. Lydia sat down next to House and handed him his bagel and a napkin; she began to eat a blueberry muffin. "Why are you covering for her?" he asked as he started to pull apart his bagel. House turned his gaze to Chase and Taub who looked extremely guilty.
"What makes you think we're covering for her?" Chase asked.
"I don't know; maybe it's the faint pink glow that came into your cheeks and rapidly turned to a lovely shade of crimson as I discovered that Thirteen screwed up."
"House, we were all in the room; Taub and I set up the patient's IV's and got the cardio monitor set. We were all asking questions and taking notes…"
"Ah, now you're turning into Pinocchio; Taub's nose grew a long time ago, yours is just starting. The only handwriting on the chart belongs to Thirteen and Lydia," House noted. "Which brings me back around to my original question: Why are you covering for her?"
"House, I think she may have gotten some bad news from the doctor," Foreman said. "She's been too tired and in too much pain to drive home more nights than she's letting on."
"Her car hasn't moved out of the parking spot it's in for six nights straight. We know why it was here last night, but the other nights…" Taub said.
"We wound up calling Slick to see if he knew anything," Chase said. "He had no idea what was up. They were supposed to have dinner one night; she begged off saying she had to work. He just found out that the woman she was seeing recently broke things off because Thirteen kept backing out of dates."
"So she was lying when she made the big deal out of having a girlfriend," Lydia noted. The three men nodded.
"Have you tried approaching her?" Annie asked "Tell her you know how she's been behaving, and ask her point blank what's going on."
"Tried that," Foreman said. "Individually as well as the three of us together. She just brushes us off."
"Too much going on right now to throw her problems into the mix," said House. "Help has been offered; if she doesn't want to take it, that's her problem." He pulled a piece off his bagel and began to nosh on it. "I'm going up to see if I can beat any more information out of the wife." House looked to his left and saw the disapproving look on Lydia's face. "I don't mean it literally…jeezes!"
"You'll attract more flies with honey than vinegar," said Lydia as she sipped her coffee.
"You're a lot sweeter than I am," House noted. "I have a pH of…negative two." House wrapped up the remainder of his bagel in the napkin Lydia gave him and put it in his pocket. "Text me when you get back with the change of clothes for me. Don't want to spend any more time than I have to in these."
"Afraid someone may actually mistake you for a doctor?" Foreman asked. House shot him a look.
"No, a janitor." Lydia was the only one in the room who understood the comment in relation to House's past, and it brought a smile to her face.
"Any preference on which clothes I bring you? Or which sneakers?" House hesitated in the doorway of the room.
"My usual fashion statement is fine; and I'll keep these for now," he said indicating his feet. "See you later."
"Bye." Lydia took a last drink of coffee; she stood, tossed the cup away and turned to the Wilsons. "Well, I guess I'm ready to go…" Lydia looked at the set of keys she pulled out of her pocket. "Oh, wait…these belong to the Sheelers. Mine are…in my pocketbook which I hid in Greg's office earlier." Lydia went to put her hand on her forehead, but stopped herself before she wound up in pain.
"Do you want me to go get it for you, Lydia?" Chase asked.
"No, thank you. I have to also get the bags with our soiled clothes in them and get them soaking or to the cleaners; although I have the feeling most of them may be ruined. Besides Robert, I don't want to spoil your reputation with the ladies." Chase looked at her curiously. "Carrying a pocketbook throughout the halls of the hospital won't get you any dates."
"True; it doesn't go with my usual style," he laughed.
"I'm going to try to catch up to Greg," Lydia said to the Wilsons. "I'll meet you in the lobby by the front desk." Lydia hurried out of the room, and turned the corner of the hallway that led to the elevators just in time to see House step inside the elevator car. "Greg! Hold the elevator!" House stuck his cane out and prevented the doors from closing.
"Miss me that much? You couldn't wait to be in my presence again?"
"I can't wait to get my car keys and pocketbook, so I'm able to drive," Lydia said as she stepped into the car. "I also want to quickly do what I can with our clothes; they've been in the bags with the blood just soaking into them; I'm not holding out much hope."
"Yours and Annie's took the biggest hit…concentrate on them. Mine is just a white shirt and some socks; the suit pants are black and they didn't get too much damage. All in all, no big deal to replace," House said as he pushed the button for the fourth floor.
"Annie already threw out what she was wearing; they were so blood soaked they probably would have been a loss anyway. Plus she said it would remind her too much of last night."
"There are going to be plenty of things in the future which will remind her of last night; the wound's too raw right now, but she's going to have to get over it. I eventually want to sample some food from that place."
"Hopefully they have take-out," Lydia noted. The elevator stopped at the first floor and the doors opened onto the lobby. House started to reach over to close the doors so they could keep moving.
"Hold the elevator!" House's hand had almost made it to the "close doors" button, when Lydia stopped him and held her hand out to block the doors from closing. "Thank you," the man said.
"Dr. Ellis," Lydia said. "Hello, how are you today?" Ellis, the orthopedic surgeon who had operated on Wilson, did a double take.
"Ms. Strohman, Dr. House," he said. "I'm fine. How is Dr. Wilson doing?"
"Well enough. Taking him in for an MRI; he's showing signs of swelling in the frontal cortex. Want to see if it's due the volume of red cells and plasma we shoved into him…or if there's bleeding," House said.
"He took a hell of a beating with the trauma he suffered," Ellis said. "Oh, could you press six, please?" House pressed the button and looked at Ellis.
"You had to spend a lot of time cleaning out the bone fragments," he said. "You're sure you got them all?"
"Pretty sure; I'd say we got ninety-nine percent of them out. Whatever might be left isn't going to cause any problems with the functioning of the unit he has in there. Who's his therapist going to be?"
"Tom Wilkinson," Lydia said. "He's a friend of ours and we're very familiar with his outstanding work." Ellis nodded.
"Tom is fantastic," he said. "Having first-hand experience with the problems involved in PT makes him an excellent therapist. Forgive me for prying, Dr. House…but since he's a friend, I take it you're working with him yourself, aren't you?" House gave him a look.
"What makes you say that?" House looked up at the floor indicator; they were almost at the fourth floor. House felt it couldn't come soon enough.
"I've noticed recently when I've seen you around the hospital, you appear to have a stronger stride, less reliance on your cane."
"He's…" House hesitated. He never talked about his leg with anyone outside of those who had become close or closer to him. But he liked and respected Ellis; he was a damn good doctor and neither took nor gave any guff. Oh, what the hell, House said to himself. He did just save Wilson from a life of being like me. "He's recommended some different medications and I'm doing therapy twice a week with him." The doors of the elevator opened as they arrived at the fourth floor. House and Lydia were both surprised when Ellis stepped off with them.
"Dr. Ellis, this is the fourth floor," said Lydia as she held the elevator doors for him.
"It's OK; I'll grab the next one. I wanted to talk to Dr. House for a minute." Oh crap, House thought; didn't Ellis just say everything went well with Wilson? Or is this going to be everything's good…but… Only one way to find out…
"What's up?" House asked. Ellis looked at Lydia and then back at House. "It's OK; you can talk in front of her. She's my personal secretary." Lydia folded her arms and gave House a look.
"Oh my; I knew you were the Director of Insurance Relations and Billings. I didn't know you held a second position as well," Ellis said giving Lydia a nod.
"She's my girlfriend," House admitted. "Which I suppose some people would say is a full-time job in and of itself." Dr. Ellis laughed.
"I never would have guessed," he said. "Dr. House, I'll make this brief; Dr. Foreman told me you have a patient in addition to Dr. Wilson to take care of, so you obviously have a lot on your plate."
"Understatement of the year," House said half under his breath. "Let's keep moving to my office; you can talk on the way."
"I know a young woman who did an internship with my office about ten, twelve years ago," Ellis began as the trio made their way down the hall. "She has gone into research with an emphasis on dealing with severe injuries to the limbs. Her work has been used by the federal government in aiding the men and women coming back from the Middle East. The nature of their wounds is catastrophic; a limb blown off is much easier to deal with medically, than one than remains basically intact, but severely mangled." House got the picture; this wasn't about Wilson, this was about him. "I was wondering, Dr. House, if you had considered the next step beyond the therapy that you're doing."
"Way too much going on to put myself out of commission at the moment," House said as he opened his office door. "Plus, I'm not comfortable in the role of patient. Every time I've played the part, I've always gotten lousy reviews."
"Please forgive the odor in Dr. House's office at the moment," Lydia said as she eyed House up to see his real reaction to Ellis' comments. "We stored a few items of clothing that were badly blood soaked in here; I'm taking them home with the hope that at least some of the things are salvageable." Lydia made a mental note to bring back one of the plug-in air fresheners she had at home. It would be a subtle yet effective way to deal with the smell.
"Good luck with that," Ellis said. "I helped out at a bad car accident a few years back. Didn't get that much blood on me, but I couldn't get my clothing dealt with for several hours. I hate to tell you I had to throw them away." Ellis turned his attention back to House. "I know you're very busy and I've always felt that doctors make the lousiest patients. But the work Liz Grady has been doing has solid reasoning behind it which is why it has been so successful. Right now, the procedures she's developed have only been used on fresh wounds; she starting work on seeing if the same principles hold fast for older injuries. I don't know anything about the nature of your wound, except that it was caused by an infarction years ago and surgery wasn't successful. It must have left you in a great deal of pain. You, of all people would be able to understand and appreciate her approach to the problems connected with muscles and nerves. I was hoping I could at least, at some point, tell you about her work." Lydia wanted to jump up and down and scream "Tell us now!" but she contained herself as she gather the bags and her pocketbook.
"What wiz-bang magical way has she found to grow muscle back?" House asked sarcastically.
"She uses the patient's own stem cells," replied Ellis. "And also uses them as the support system to strengthen the area as the tissue takes." House was taken back as was Lydia; Ellis took advantage of the break in the conversation to continue speaking. "If you have a building that's falling apart and weak, what do you do to shore up the structure before you begin repair work?"
"Put up scaffolding," said House, now intrigued by what Ellis had to say.
"Exactly. The scaffolding in the case of the patient is made of stem cells from their own body, therefore lessening the chance of rejection to near zero. The work on the replacement muscle tissue also uses the patient's stem cells…I would go further into the details, but it would take a while." Lydia looked hopefully at House. There would be no harm in just giving the information a once over…but she knew him well enough to know he was just going to brush Ellis off.
"The idea is a unique and very sensible approach to things; but I'm sure I have far too much missing from my Silly Putty glob of muscle to make it worth the effort to try…" House began.
"Dr. House, I'm sure you've seen the horrific pictures of the soldiers coming back from overseas. The work Liz has done is amazing and she's aligned with the staff at the New Jersey Institute of Technology, so you wouldn't have to travel very far to receive treatment, or even take a first-hand look at her work. Look, it's not going to fix everything; you'll still have some pain, and therefore be on medication. And you'll never do less than ten seconds in a hundred meter dash…but things could be a lot better. It depends on exactly what state you can work your leg into prior to treatment, and how hard you're willing to work for it." House could see that Ellis was enthusiastic about his protégé's work, but now was not the time to be thinking about himself. He knew how often people called him self-centered in the past, and many a time they were right. But right now he was more concerned about the practical medicine that could be applied to Wilson, his patient and his mother rather than Gray's book of anatomical fairy tales.
"I appreciate your taking the time to inform me of the work your former intern is doing. Maybe when everything calms down around here, I can look over the spec sheet on things and play Q and A with you. But for now…" Ellis held up his hands.
"I understand, Dr. House; I just thought you ought to know about the work being done in this area." Ellis turned to leave, then stopped. "Oh, what time are you bringing Dr. Wilson to the I.C.U.?"
"Ten. Once he's settled in, he'll be prepped for the MRI," House said as he started to look at the mail that had been dumped on his desk.
"I wouldn't be interfering if I stopped by to check on him, would I?"
"Nope, knock yourself out and earn that inflated bedside visit fee; far be it from me to stop you," House replied. Ellis wasn't sure how to take what House said, so he let it drop.
"I guess I'll see you down there later." Ellis extended his hand to House, who took it with less reluctance than usual. He kept in the back of his head the debt he owed Ellis for his help to Wilson. Ellis turned to Lydia. "Take care, Ms. Strohman; I know you've had a rough time with all of this, too."
"Thank you for everything," Lydia said as she took his hand. "I'll be fine." Ellis smiled and nodded, then turned and left House's office.
"So, are you at least going to consider looking into what Dr. Ellis was talking about?" House looked over at Lydia as she picked up her pocketbook. She had placed her handbag and the bloodied, bagged clothing in the conference room to start to relieve the smell in House's office. He had sat down; the precious few minutes he could afford to sit here was invaluable to him.
"I will admit it's based on a solid idea. The majority of problems with any kind of transplant or artificial device is rejection by the body; that and infection. I doubt it would work for me though."
"Hmm…no probably not," Lydia said as she fished her keys out. "Not when you've already made up your mind it's going to fail." House opened his mouth, then closed it and looked away from Lydia. She took a step closer to him and bent over. "You're not in a good state of mind to even make an attempt at an objective opinion on the subject. Wait until you can have an open mind with it. But don't write it off before you've even had a chance to look at it." She moved in to give House a kiss, but had to back up when he suddenly stood up. She was surprised when he gathered her in his arms and gave her a long, gentle kiss. When he finally moved his head back, he continued the embrace by pulling Lydia in and resting his head on her shoulder. She didn't know what prompted the display of affection or why House decided to engage in it here of all places. They were careful to keep things to a minimum around the hospital; that, at the moment was thrown out the window.
"Are you OK?" Lydia asked when she had a chance to look at House. He was pale, except for the dark circles under his eyes that were so pronounced, they gave the appearance of bruises. Not that the discoloration took anything away from the beauty of House's striking blue eyes; but the wear and tear of the past twelve hours were clearly taking their toll.
"I'm fine. I just…" Lydia followed his eyes and realized that he was looking at the bandage on her forehead. She looked down as he picked up her hands and lightly touched her wounded fingers. "I needed a few minutes with you. Last night was one of the first times in a while that I was going to be able to fall asleep and wake up with you in my arms…and have a bunch of fun in between. I feel cheated that we didn't get to have that." Lydia smiled; unbeknownst to many people, House could be incredibly sweet and tender…like right now.
"I missed that, too," Lydia said. "It has been a while since we've had more than just an hour or two to ourselves. It's been harder than I thought it would be to juggle work with my schooling, the kids' school, their soccer, music lessons…if you didn't pitch in and make dinner a couple of times a week, and stop at the stores for things we need…"
"It's self-defense; I don't want to go hungry," House said with a little smile. "Look, I told you from the beginning: I am behind you on the idea of completing your education. It was a crime it was denied you all those years ago. You finish your Bachelor of Science, then see which of the graduate programs you want to take."
"Greg, if I try to go beyond a Bachelor's degree, either you'll never see me or it will take me years."
"So if it takes you ten years to get your doctorate, you'll still only be fifty-one," House said as he put his hands on her shoulders. "As I'm finding out, it's not a bad age to start your life over again. You're too good not to take the next step."
"I'm not trying to put blame on anyone else, but Greg, my notes were there and I think they were very clear. I'm worried about Thirteen." House sighed as he took a step back and away from Lydia.
"I'm not happy with the situation either; nor is my team. Which all makes for a bunch of distracted doctors, and right now that is the last thing we need around here."
"I know you're going to say something to her when you go to the lab now; please tell her if she needs help with anything, I'll be glad to do it. If she needs a ride to the doctors or…"
"Slow down. I'm looking to spend more time with you not less," House reminded Lydia.
"I know; I just feel sorry for her. She watched her mother waste away from Huntington's; it's got to be a terrible thing to live with," Lydia said as she ran her hands down House's arms.
"OK, I agree with you. Now can we get back to us?" House hesitated for a moment. "It's very unsettling to be having hallucinations without the benefit of the substance that put the crazies in your mind." Lydia was puzzled by his statement. "I wasn't even there, but I keep seeing images of the three of you…Wilson getting shot, Annie bloodied and screaming…you with a gun to your head…" House closed his eyes and shook his head. "And it's not even that I'm seeing the images when I've tried to sleep; I saw them when we were outside talking to my mother, when we were in with Wilson…I haven't even had a drop to drink or a pill of any kind and this is happening." House opened his eyes, but couldn't bring himself to make eye contact with Lydia. "I'm scared. I haven't had anything like this since I detoxed at Mayfield."
"You weren't there," Lydia said guiding House to his desk chair. "But it's almost worse, because the more active your imagination, the more vivid and horrid the images you can conjure up. I've always gotten more scared at horror movies that don't show what was happening, but rather just people's reaction to it." She reached over and ran her hand down House's cheek. "You haven't had proper or enough sleep, you have far too many things dividing your attention, and even though the food has been wonderful, you're not eating on a normal schedule. What you have eaten, hasn't stayed down because you've gotten yourself so twisted in a knot. At some point, you're going to have to take a step back." House let out a deep breath.
"I'm not going to be able to relax until the MRI confirms that Wilson is OK, until my patient stops lying to us so we can help him, until I go see my mother, and until I spend at least twenty-four hours straight naked with you. Since none of those things are likely to happen any time soon, I guess I better learn how to share my world with the heebie-jeebies." House stood up and gave Lydia another kiss. "Go do what you have to; I'm going to see what secrets our patient's been hiding." Lydia gave House a quick hug, picked up her belongings and hurried down the hall to the elevators. She knew if she stayed with House too long, she'd keep trying to convince him to take a break and that would only piss him off. The elevator came quickly and she tried to put her concerns for House to the back of her mind on the ride down to the lobby. When the doors opened, and Lydia stepped out she spotted the Wilsons very quickly.
"I'm sorry; we ran into Dr. Ellis. He's the one who did James' hip replacement surgery. He said James did well, and he was very pleased to hear that Tom was going to be doing therapy with him," Lydia said as she and the Wilsons passed through the hospital doors.
"I'm very glad that the doctor feels that James did well," Claudia Wilson said. "When will he start therapy?"
"The thinking nowadays is to get people back on their feet…literally…as quickly as possible. So I would guess either later today or tomorrow morning."
"What? That seems awfully fast," Henry Wilson said.
"Well, you had people poking around in your heart, and I'm willing to bet you went home the next day," Lydia said. Henry nodded, realizing Lydia was right. They had reached the Wilson's car and Mr. Wilson pulled out his keys to disarm the alarm. He seemed to be having difficulty.
"Damn thing! The blasted alarm is different from the one on other car we have, and I can never get used to which button I should push." Mrs. Wilson went over to give her husband a hand; in few seconds, the alarm was off and the car was unlocked.
"He doesn't handle things too well when he has a lot on his mind," Mrs. Wilson said quietly to Lydia. "But as soon as James is back on his feet, everything will be back to normal." It's going to take more than that to get things back to normal around here, Lydia thought to herself. A LOT more…
House made his way to the lab that he and his team used exclusively. If mistakes were going to made, if screw-ups were going to happen, they were going to be confined here, not shared with the rest of the hospital community. Then again, the mistakes of the hospital techies at large wouldn't contaminate their results. He entered the lab and found Thirteen at one of the tables with a microscope, holding her head in her hands.
"I don't mind you taking a nap, but our patient is probably keen on keeping as much of his foot as possible. What have you got?" House asked as he moved next to Thirteen.
"I…I wasn't napping; I had just closed my eyes for a minute," Thirteen said with an edge in her voice. "You can take a look," she said moving aside so House could see the view in the scope. "It's not jumping out at me with anything that would make sense for the patient."
"Nothing may make sense for the patient until we find out where his lie is making its nest. I was ready to go in with a verbal machete and cut swath through to the truth with the dear Mrs. I have a feeling the wife doesn't even know what that may be," House said as he looked through the microscope. He looked for a moment, then turned to Thirteen. "Any of your doctors tell you to go get glasses?"
"No. Why would…"
"Because one of the reasons this slide doesn't make sense is you have it upside down," House said as he took the slide out and placed in its proper position. "Why have you decided to turn this place into your own personal hotel?" House moved the eye lens until it came into focus for him.
"I've had a few nights where my migraines have worn me down; I thought better safe than…"
"Vibrio!"
"Excuse me?" Thirteen asked. House pulled out the slide, and put another one on the viewing platform in its place. He again fiddled with the eye piece.
"Adjust this any way you want so you can see it; IF you can see it," House said with a certain feeling of triumph. Thirteen stepped over to the microscope; she twisted and turned the lens for several moments. "Still can't see it clearly, can you?" Thirteen controlled her tears as she stepped back.
"What is it?"
"Vibrio Vilnificus. It's a water-borne bacteria found in brackish salt water. Had one other case in the past ten years or so. This guy is how old? In his twenties?" Thirteen nodded.
"Twenty-six, with no health issues other than the recent case of poison ivy…and the fall from the ladder at work," Thirteen added in sheepishly. House eyed her up and down.
"You didn't see what Lydia wrote on the info sheet because your eyes couldn't focus on it. That's also why you wrote the information you got from the wife in print rather than script; you were afraid you wouldn't even be able to go back and read your own handwriting. And you don't have the usual doctor's scrawl. You have soft, feminine strokes to your handwriting…"
"House! Just stop being an ass and…let me help you get through this case and things with Wilson. Then I'm requesting a leave of absence." House was surprised, but held his reaction in check.
"Right now, you're more of a distraction rather than a help around here; even Lydia told me to convey her desire to help you. And what makes you think I'll OK a leave of absence?"
"Damn it, House! I know what you're trying to do! You don't need to know what's going on in my personal life; you have no right to…"
"I have every right to know what's going on when it affects your job performance." House was raising his voice; partially because he didn't need to be dealing with Thirteen's problems right now, and partially because he was genuinely concerned. Thirteen sat down on one of the stools nearest the microscope. House gave her a minute to gain her composure before he started playing inquisitor. "How much brain shrinkage has there been?" Thirteen looked at him in shock.
"How did…I shouldn't even ask; you're House," she said as she rubbed her head. "Slightly less than one percent, but it's the fact that any shrinkage has occurred that's worrisome. My doctor believes in being aggressive, which I have no problem with. There's a new treatment that's come out of Johns Hopkins and has FDA approval. My concern is that insurance may not cover it since it's so new." House took a few steps away and turned back to Thirteen.
"This set-up is so fraught with ironies it's not funny. The treatment has government approval, but insurance companies can refuse to pay for it because there isn't a history of success in the field; and of all the professionals on the face of the earth, you, a doctor has to worry about getting proper health care. Boy, does that suck." House looked at Thirteen as she sat with her head down. "What makes you think a leave of absence will help?"
"You said to me a few months back, you need Thirteen, not six point five. I don't know that if I take the treatment, I can do my job properly on a regular basis." House thought for a moment.
"The last time I gave you a leave of absence, it was so you could spend six months in jail for euthanizing your brother," House said referring to the delusion he had in the medical coma he was in after the crane collapse. "Things just went downhill from there. Get the full lowdown on what the course of treatment would entail; we'll find a way to work around it." He walked over to where she sat. "Migraines are a separate issue from the Huntington's, but the migraines are affecting your vision. When are you doing something about that?" Thirteen shook her head.
"I've had three appointments in the past month with the optician and I've had to cancel each one because I didn't feel up to driving." House nodded.
"I still don't get the nature of your relationship with Slick, and I'm not sure I want to know. I do know he'd jump through hoops for you if you'd just tell him what's going on. Which brings me to the subject of your three teammates; tell them what's going on. They're worried about you. And talk to Lydia about setting up a time when she can drive you; mention the insurance situation as well. If anyone can find a way around the bureaucratic BS that goes along with the insurance industry, she can." Thirteen nodded. "Want to help me go play good doctor/bad doctor with the patient and/or his wifey-poo? I call dibs on the bad doctor role; it comes naturally to me." Thirteen managed to laugh. The whirl of a machine on another counter caught their attention.
"The re-do on the patient's blood work," Thirteen said. She pulled the sheet of paper off of the printer. Thirteen did her best to read it, but one particular reading that was designated as out of the normal parameters caught her eye. "House, check out his white cell count." House took the paper from Thirteen. The report had designated the reading as abnormally low. "He has a raging infection in the leg; even I can see that," Thirteen said. "Those numbers can't be right." House made a face.
"They shouldn't be right, but they are. We've answered the what; we now have to find out why," he said as he got the far-away look that those used to working with him knew so well. "Let's see what information we can get out of them." House started out of the lab as Thirteen grabbed the printout to include as part of the patient's chart. As they waited for the elevator, House checked the time on his cell phone; it was a few minutes before nine. The timing would work out well; he'd have time to talk to the patient and get back to Wilson before they began to move him. He sent a text to Chase, Taub and Foreman telling them to concentrate on any water rescues Kevin Sheeler had gone on; since House had identified the bacteria as vibrio, he told them to look for anything bringing him in contact with salt water in particular. The location of both of Sheeler's fire houses were too far inland for it to be a normal call, so he also clued them in to look for disasters: large fires, a natural disaster like a hurricane, a boat fire, etc. While House's natural curiosity had wanted to know exactly how and where this guy made contact with the bacteria, his biggest concern right now was why was there such an abnormality in the white cell count? In House's mind, the fall from a ladder on the job was the source of the problem; but how to connect the dots? What was this guy taking that could so alter his WBC? House could list several things, none of which would be readily available without a prescription.
"House?" Thirteen was holding the door to the elevator waiting for House to exit. He made his way off the car and started down the hallway to I.C.U. When they got to the ward, House quickly looked over the room Wilson was going into; it was perpendicular to the room where his patient was. It would make it easier to tend to both of them at once. House was pleased to see that several Geri-Chairs had already been set up. He had a feeling he was going to have company in keeping watch over Wilson: Annie and Wilson's parents were probably going to be his roommates. He hoped Wilson's dad didn't snore as badly as Annie said he did.
"Mrs. Sheeler? Hi, how are you doing?" Thirteen asked as she stepped into the room.
"Dr. Hadley? That's your name, right? I'm sorry, I'm not thinking straight right now. Kevin keeps waking up, talking for a few minutes and then falling back asleep," Susan Sheeler said.
"He's not falling asleep, he's passing out." Thirteen shot a look at House.
"Mrs. Sheeler, this is Dr. House, the head of the diagnostics team." Susan Sheeler looked up at House.
"Have you been able to figure anything out with my husband?" she asked hopefully.
"We're only part of the way there," House said as he rested his cane against the end of Kevin's bed. He picked up the sheets to look at the fireman's leg and foot. He finally had a good view of what everyone was referring to as a deflated leg; while the outer skin was just starting to deteriorate, the inner tissue was clearly gone. House became even more unhappy when he saw Kevin's toes: the pinky toe and the two next to it were rapidly progressing from livid purple to black. The remaining toe and the big toe showed slight discoloration. He replaced the sheet, and sat down in the chair nearest Susan Sheeler. "He has a bacterial infection known as Vibrio Vulnificus. While usually fatal to older people, and people with compromised immune systems, a young guy like your husband should be able to put up a better fight." Mrs. Sheeler let out a sigh of relief.
"Oh, that's wonderful! So he's going to be OK?" she asked.
"You didn't listen carefully to everything I said," House said tersely. "I said he should be able to fight it off; but there's something of a mystery that we're hoping you can give us some clues to." Susan Sheeler's expression changed from joyful to scared.
"Why…why what's wrong?"
"Something is destroying your husband's immune system. Considering the type and extent of the infection he has, his white blood cell count should be through the roof. It's not…it's way below normal," House explained.
"Well, how did my husband get this bacteria? Does it have anything to do with the poison ivy he had?"
"Yes and no," Thirteen said. "The fact that he had an open wound when he came in contact with the bacteria, gave it easy access to get inside of him."
"He would not leave his leg alone!" Susan said. "I told him he should cover it, out of sight out of mind sort of approach."
"It's not just that," said Thirteen. "Years ago the thinking was to let a wound be exposed to the air, let it breathe. But what research discovered is that if you don't cover it, you're more susceptible to dirt and bacteria getting into the wound."
"Several weeks ago, your husband had a fall off a ladder at work. Has he been seeing a PT for that?" House asked. Susan Sheeler shifted her weight back and forth in her seat; she dropped her head down and wouldn't make eye contact with either Thirteen or House.
"Kevin was lucky; his fall was broken by a large set of bushes that were growing next to the house. He went to our regular doctor, but he refused to go to see a physical therapist. He was nervous about what the PT would say; if he said that Kevin couldn't work…we'd be in trouble. I already had to stop working because of complications with my pregnancy…we couldn't survive on Kevin's disability pay." Susan was doing her best not to cry.
"Mrs. Sheeler, can I get you some cold water or juice?" Thirteen asked.
"Just some water would be fine." Thirteen left the room to refill the pitcher on Kevin Sheeler's bed tray.
"How has your husband been dealing with the pain since the fall?" House inquired.
"He started out with Advil, then one of the guys at the house told him to switch to Aleve. It didn't seem to do any better for Kevin, but he's not one to take pills, so he didn't want to experiment. He said he'd just continue with the Aleve and go with it. It must be helping a little bit; he was able to go to that training seminar down south a few weeks ago." Thirteen had walked back into the room as the wife revealed that her husband had indeed traveled; just inside the US, not abroad.
"Do you know if he did any training in the Gulf of Mexico? Or did any fishing or swimming in the Gulf?" House was now tapping his cane up and down; he felt like he was near to finding an answer.
"I don't think so…the only water he mentioned was Lake Charles in Louisiana." Damn! House thought. That removes the possibility of salt water contact there. Lake Charles was fresh water.
"You said he doesn't like to take pills," House said indicating Kevin. "Any chance one of his buddies at work would help him out with his pain problem by supplying some happy stuff?"
"What? You mean like Oxycontin or Vicodin?" Susan shook her head. "I can't even get him to take vitamins. I can't swear to the fact that no one's given him anything and that he hasn't taken it; but I would be shocked."
"You wouldn't be the first unsuspecting spouse," House noted.
"Dr. House, if you can find out what's messing up his immune system…can you do anything for his toes and foot? I saw what the toes look like…"
"It's only because he came into the hospital when he did, and we got him on the right antibiotics as fast as we did, that he's going to live," House said seeing the terrified look in Susan's eyes. "Normally, the antibiotics would be aided by the body's immune system; since he has very little left, if he has any by the time this is all over…we'll see how much of his leg we can save," House grimly said as he stood up.
"No...No! Kevin's the third generation in his family to be a firefighter…it's all he knows," Susan Sheeler said as she sobbed. "He's strong, trains for work all the time; he's the youngest decorated firefighter in the department's history…"
"He's got to be a tough guy to be in his line of work," House said. "It takes a certain kind of craziness to do that job. He'll find a way." House turned and headed for the door of the room; he pulled out his phone and saw it was nine-thirty. Almost time to begin the Wilson parade. House became aware of Thirteen coming alongside him.
"So other than the training trip to Louisiana, nothing new," Thirteen said.
"That and the fact the guy wouldn't take a pill even if you put a gun to his head," said House sounding disgusted. "The guy can't be getting through the pain from the fall just on sheer will. Either there's something the wife isn't telling us, or something he isn't telling the wife." They reached the elevators, and as House was about to push the call button, he got a text:
Hi, Hon! Got your clothes and some things for Annie and James. Should I meet you at your office?
House replied in the affirmative; he would let Lydia know what they found out on "her" case when he saw her. He and Thirteen stepped into the elevator when it arrived and took it up to the fourth floor. As they got nearer his office, House saw that the Wilson fan club had relocated to his conference room. Not only were Taub, Chase, and Foreman in there, so were Wilson's parents, Tom and Slick. He also saw that the food from Cheery Valley had moved in as well; it was fine with House since he was getting hungry again.
"Hi," Lydia said. She had been in House's office, but now came out to greet him. "The guys told me you had figured something out with the case, but they wouldn't tell me what. They said that privilege should go to you." House passed by Lydia, went into his office and grabbed his red mug. He made his way over to the coffee urn and started to pour himself a cup.
"Vibrio," he said as he stirred the drink.
"VibrioVulnificus?" Lydia said with surprise. House turned and leaned against counter by the coffee maker.
"Keep going," he said as he took a sip from his mug. Lydia thought for a moment.
"It's a waterborne bacteria, usually brackish salt water…he's a young man!" Lydia said, changing her train of thought. "He's on cephalosporin and doxycycline. Those two should fight the bacteria with no problem."
"It's a problem if the meds are getting no help from the body's immune system," House said. "His immune system's trashed. Right now finding out why would just fit the last piece into the puzzle."
"Is he going to die?" asked Claudia Wilson. House dropped his head down.
"No; the question is how much of his leg is going to die. Hopefully we can keep the amputation below the knee joint." Annie came into the conference room just in time to hear House's dire pronouncement for the young father-to-be. She had gotten changed into leggings and an oversized sweatshirt that Lydia had brought to her.
"Greg, I'm so sorry about your patient," Annie said as she came over to Lydia. "He came to the hospital too late to get help it sounds."
"It wouldn't have been too late if he didn't try to medicate himself," House said.
"House, we can't prove that," Foreman said.
"Yet," House replied.
"Well, we're not going to find out anything from the firehouse where he works," Chase noted. "All requests for information have to be in writing and submitted to the superintendent's office. I told them the urgency of the situation…I was simply given the address to send the letter to."
"Doesn't surprise me," Slick said. "However, firefighters like cops are a brotherhood. You can probably get information out of one of his house mates…off the record, of course. Let me try to look a few things up…" Slick said as he worked the buttons on his cell phone.
"Maybe we can ask Mrs. Sheeler for a few names," Lydia suggested. "If we stress that his co-workers would be talking off the record, perhaps some information can come from there."
"Worth a shot," House said. "Let me get changed into normal clothing; I'll meet you back here so we can form the conga line to bring Wilson to I.C.U." House took the things Lydia was holding out to him. He smiled when he saw she chose the Rolling Stones T-shirt she had bought for him when they first got back together. She also brought a white button down shirt and a gray tweed jacket plus jeans; that, plus his sneakers, and he would look like House again. In a matter of a few minutes, he was leading the crew down to recovery; there was no need for all of them to go, but they wanted to. As they arrived at the doors, House knew everyone couldn't go in.
"Fraulein, Songbird…you two come with me. The rest of you wait here; parade will be starting shortly." He pushed the door open and saw a sight that made him smile: Wilson was awake, sitting up, and talking to the nurse, Alicia who was taking care of him.
"Hey, look who's here," Alicia said.
"Finally; I was wondering where the hell you were," Wilson said. He looked Annie up and down. "You look much more normal now; it looks like you've even combed your hair." Wilson cringed and put his hand up to his head.
"It is so much fun hearing you sound like me," House said with an exaggerated smile.
"Well it's not fun for me; I don't like hearing myself sound like you," Wilson said. Seeing Lydia had changed into dress pants, a silk blouse and a jacket, Wilson smiled. "I see you're back to your usual professional, beautiful self," he noted. "As opposed to your boyfriend who would never think to put on a suit and tie to come to work."
"I would, but I wouldn't want you or Foreman to accuse me of being a copycat," House said. Wilson gave him a look, then closed his eyes.
"House, is there any way I can get something to eat when I get up to I.C.U.? Don't mean to be a pain, but I'm starting to get some pains in my stomach, it's so empty."
"We can get you something; it'll still be mainly liquids, but maybe we can sneak a few solids in. You can have some juice before the MRI, the rest will have to wait until you get back," said House glancing up at the monitor. Everything still looked good. He couldn't hide a smile as he looked at Wilson's Foley bag.
"How's it looking?" Wilson asked anxiously.
"Less like beef broth and more like strong tea," noted House. "You've got a ways to go, but soon your pee will be back to its usual sunny yellow. I'm going to check your chart." House went over to the nurses' station; Alicia had seen him coming and had Wilson's chart waiting.
"He had a good rest," she said. "He didn't wake up until nine-fifteen."
"Wish I could say that," House said. Wilson's readings were all good in the two hours or so since he had last seen him. House authorized Wilson's release from recovery and transfer to the I.C.U. He returned over to Wilson's bedside. "Just signed your get out jail free card. I see your orderlies are here to handle your float."
"House, Lydia was just telling me about that fireman that came in to the clinic. Vibrio? In someone that young…"
"I know," House said cutting him off. "I've been over this too many times in my head. It's not even that he waited too long to come in; it's whatever he did to self-medicate that's proving his downfall."
"I'm really sorry," Wilson said. "Despite what you say, you really do care about the well-being of all of your patients; but one with a leg injury hits really close to home." House looked down and away from Wilson.
"Yeah, it does." The orderlies came over with Wilson's chart in tow; Alicia did the final unhooking from the monitor.
"Good luck, Dr. Wilson," she said.
"Thanks," he said giving a wave. When the stretcher came through the door into the hallway, everyone gathered outside started to applaud. "Oh, please…no…give it a break!" Wilson protested. He high-fived Taub, Chase, and Foreman, and took a kiss from Thirteen. "Thanks for your help," he said. Wilson rolled his eyes at his parents as each came forward for hugs and kisses. He shook hands with Slick and turned to Tom as he stepped forward. "I hear we're going to be spending a lot of time together," Wilson noted.
"Yes, we are," Tom answered as they shook hands. They had to take two elevators up to I.C.U. and all of them obviously couldn't stay in Wilson's room. So, House, Annie and Lydia stayed with Wilson; once he was set, they could rotate out, and let Wilson's parents come in.
"I'm going to go check on Kevin Sheeler," Thirteen said.
"Tell Mrs. Sheeler I'll come by in a little while and say hi," Lydia said. She watched as they hooked Wilson up to the monitor in his new location. House had dropped off Wilson's chart with instructions to set him up for the MRI once he had signed the consent.
"Here, I'll let you do this," House said handing a container of apple juice to Annie.
"Oh…I love you," Wilson said.
"I know you do," House said. "You ought to tell Annie you feel the same way." The four of them smiled at each other.
"This is now getting back to normal," Annie said as she offered her boyfriend the straw.
"House? We have a problem." Thirteen stood at the door to Wilson's room. "It seems Kevin Sheeler woke up briefly; after his wife clued him in as to what was going on with him, he told his wife he doesn't want us going in their house. He's unconscious now, but…"
"Let me guess," House said. "They want their keys back."