The ER looks and feels very different from the perspective of a patient and, I decided after not more than thirty seconds of the patient experience, it was not a good thing. There was a bustle of activity as the remnants of the Santa suit were cut off along with my clothes, while various monitors were attached to my finger, chest, and arm. I tried not to think about how much I'd have to pay for that stupid suit now lying in shreds on the floor. An oxygen cannula was inserted into my nostrils and the rush of cool air felt surprisingly good.
An ER nurse I didn't recognize started an IV in one arm while a second tech took my vitals. He must have thought that, being a doctor, I would care, not recognizing that right now I was much more patient than doctor. Pulse 132, BP 110/60, respirations 24 and temp 99.6. So, I was tachycardic, but BP was normal and the elevated temp probably reflected the hour I'd spent in that stupid Santa suit. EKG leads magically appeared on my chest, arms and ankles.
The cubicle's curtain swished. "Dr. Wilson!" I didn't need to open my eyes to know the voice belonged to Allison Cameron. Of all days for her to be on duty. I trusted her, but it was still Cameron.
"Dr. Wilson?"
Huh? I felt her cool fingers settle gently on my forearm. My eyes opened to meet her deep brown ones, filled with concern.
"Tell me how you're feeling." Of course Cameron would ask the question that way. House would have simply demanded a list of my symptoms, but Cameron wanted to know how I felt.
"Like crap," I answered truthfully, evoking a tight smile from my doctor.
Cameron asked me to describe my chest pain – where it was located, whether it had changed location.
Burning and aching, under the breastbone, steady on one side only. I knew the drill.
"Pain on a scale of one to ten?"
Not a ten, I thought as I absently rubbed my chest. Now that I was here, safe and sound in the ER, I wasn't nearly as scared, but my semi-reclined position hadn't really eased the pain. "Six."
Cameron spoke to the techs, ordering pain meds as well as the standard blood work for a possible MI. Having her confirm my fears started my heart racing again. "Try to relax, Dr. Wilson. We're going to take good care of you." Relax, right. No problem. Cameron unwrapped her stethoscope from around her neck and listened to my chest.
As Cameron finished and stepped away from the gurney, another tech appeared at my side. "Hi, Doctor Wilson, I'm just going to take some of your precious blood." She looked familiar but I couldn't make out the name on her security badge. Tammy or Teri or something like that. My arm was secured in a vice grip. "Big stick," she said as she jabbed the needle into my vein.
"Did the pain come on suddenly?" Cameron was at it again.
She clearly wasn't referring to my now throbbing arm. "Maybe an hour ago."
"Are you experiencing pain anywhere else?"
She was going to kill me with these questions. I mentioned the pain in my left arm and she dutifully jotted down my response in the chart.
"Am I having an MI?" That was the only important question – and the elephant in the room.
"Well, your EKG looks good," Cameron said, nodding to where the machine was dutifully recording the tracings of my heart. "No ST-segment elevation, or signs of ischemia—"
The curtain swished open to reveal a clearly agitated House. For a moment, he simply stood there, eyes pinched, forehead creased, as if his brain was trying to confirm what his eyes were seeing. "What the hell happened to you?"
Two thoughts immediately hit me. First, when House entered a room, it was if God Himself had arrived – or maybe the Devil. The second was that, somehow, House's single gruff question was more comforting than all of Cameron's doting. I didn't know how he'd found out about me, but my relief at House being here was immediate and overwhelming. Cameron was a competent doctor but I trusted House more than anyone else to figure out what was wrong with me, to keep me from dying, and especially to keep me from dying in a Santa suit on Christmas Eve.
Cane in hand, House crossed the short distance to my bed in two steps, grabbing the chart from Cameron's hand and almost body-blocking the medtech out of the way. I'd seen House spend hours poring over a chart, searching for the one scrap of information that would solve his case. I'd also see him glean more from a cursory review than most physicians would learn in several hours. My chart got the cursory review and, within what seemed no more than seconds, his blue eyes were back on me.
"What happened?" he again demanded.
Where to start? While I was trying to decide, Cameron answered on my behalf. "He was brought into the ER fifteen minutes ago, complaining of—"
House's gaze never left me. "Let him talk."
Anyone else would have thought House was angry. From experience, I knew differently. The fact that House had yet to make a snide comment meant he was scared and that turned whatever momentary comfort I'd felt back into panic. "I had chest pain," I managed and, trying to sound at least somewhat clinical, added, "radiating to the left arm."
"And tachycardia," Cameron added, earning a glare from House.
He grabbed a stethoscope and leaned over me, roughly pushing aside my gown. Most doctors would have warmed the bell; House didn't and I couldn't restrain a slight shudder as the cold metal pressed on my chest. House, intent on listening, didn't notice or, more likely, didn't care.
My eyes watched his face, searching for a clue as to his thoughts, his diagnosis. His focus, however, was somewhere on the wall behind me. At one point, his eyebrows narrowed, and I tried to decide if that was good or bad. After repositioning the stethoscope and listening some more, he suddenly snapped the instrument from his ears and stood up. Some of the tension seemed to have dissipated. "Sounds okay," he said to no one in particular.
I released a deep sigh as the tension in my own body eased just a bit. I was starting to hold out some hope that it wasn't an MI, but the accumulation of my symptoms still needed a name.
House grabbed again for the chart. "Where are the results of his cardiac enzymes?"
"Still waiting," Cameron replied.
"EKG?"
"Bit of sinus tach; otherwise normal."
He turned to me with a look that was now more curious than worried, morphing into the diagnostic genius facing another medical challenge. "Tell me about the arm pain."
House had left me mostly uncovered and I shivered again. Cameron reached to pull up the blanket when House's arm shot out to stop her. "He's cold," she said.
"He'll be a lot colder if he dies." He tapped on the bedrail. "Arm pain, go."
I shrugged, which actually brought the pain to the forefront. "It hurts."
House rolled his eyes and his head simultaneously. "De. Scribe. The. Pain." The tone was one reserved for his most annoying patients and colleagues. And, sometimes, me.
"Stings when I move it."
Cameron was hovering again. "Do you need more pain medication, Dr. Wilson?"
"No," House answered for me. Easy for him to say. House limped around the gurney and started palpating my left arm. His second violation of our unspoken "no touching" rule in one day. That alone spoke volumes.
"What'd you eat and drink today?" he asked when he'd finished and haphazardly folded the blanket over my torso.
It was often difficult to follow House's train of thought when I was healthy and engaged – in my present condition, it was downright impossible. "Coffee and danish for breakfast. Late lunch – turkey, stuffing, potatoes – the usual Christmas dinner." For most people, I mentally added, thinking about the pizza and porn.
House just stared at me for what seemed like at least a minute. "Wilson, you're an idiot," he said.
I'd take being an idiot so long as I wasn't an idiot having a heart attack.
"You too, Cameron." House pointed at the cubicle's only chair, and the remaining tech moved it closer to him. He slowly sank into it.
A tech rushed into the room, paper in hand. "Lab results," he announced. House snatched them out of his hand and, after a brief glance, handed them to Cameron with a self-satisfied smirk.
"You're fine," House said with a heavy sigh. "Well, mostly fine." He again nodded at the ER tech. "You can start getting him ready to get out of here."
"He needs a cardiac consult," Cameron said.
"No he doesn't. Not a cardiac problem. EKG and enzymes are normal."
"But his chest pain—" Cameron asked.
"Heartburn after a meal. Classic GERD."
"And the pain in his left arm?" Cameron was not to be deterred.
House sighed, leaned forward over his cane. "Our do-gooder St. Nick here ate a heavy meal before taking off on his one-horse sleigh. But instead of actually using a sleigh – or even a wheelchair – he decided to carry the Santa bag filled with lots of toys for good little girls and boys all by himself. Not to be mistaken for Arnold Schwarzenegger, and being a lefty, he strained his triceps slinging that stupid bag up and down over his shoulder. Then the GERD kicked in. Our friendly Kris Kringle, already hot under his velvet collar, felt the heartburn, mistook it for chest pain and started to panic. Tachycardia ensued – helped along by his daily massive caffeine intake. Convinced this would be his last dash through the snow – or at least the dying kiddie ward, our friendly Santa went into full panic mode; chest pain got worse, palpitations increased and, presto, all the signs of an MI. Only thing missing was – oh, yeah, the actual infarction."
House delivered his pronouncement with his typical combination of sarcasm, condescension, and pontificating. And, as always, it made perfect sense once he explained it.
I wasn't dying, not even close. "You think I have GERD?" Gastroesophageal reflux disease or, more commonly, acid reflux. Annoying but infinitely manageable and treatable. I let my head fall back against the gurney, and my eyes to close.
"Dr. Wilson, I really think you should stay overnight for observation," Cameron said to me.
I'd been unhooked from all of the monitors and one of the nurses had found me a set of scrubs to wear home. I understood her concern and, if I'd been my doctor, I'd have probably tried to keep me here. But I was a doctor, had looked over my own chart, and knew I'd be okay – actually a lot better – at home. I said as much to Cameron.
"You shouldn't be alone tonight." Her voice took on an almost pleading quality.
"That desperate for a date?" House asked from his seat.
She turned on him with her usual mixture of frustration and despair. "House, you're a doctor, you know that after having a cardiac incident—"
"That wasn't a cardiac incident," he finished smoothly. "Go take care of sick people. Leave Wilson to me."
I couldn't restrain a small grin. She must have seen it because she gave me an icy look before turning to leave.
"Cameron." My voice stopped her at the edge of the cubicle. "Thank you."
I was rewarded with a smile. "See you tomorrow, Dr. Wilson."
When she was gone, House pulled himself out of the chair. "She's right, you know. You shouldn't be alone tonight." It was as close as House would come to showing that he cared.
"Don't think I'm up for pizza," I said.
"How about milk and cookies? Perfect for a Santa with GERD."
"You don't have milk and cookies and the stores are closed."
"7-Eleven's open." He started walking out of the cubicle.
I trailed after him. "If you let me watch It's a Wonderful Life, it's a deal."
"I'm not watching that stupid movie."
"My heart's not up to porn," I replied.
"Don't think they've made It's a Charlie Brown Hanukuk."
I smiled. I could have said thanks. I could have wished House a merry Christmas. But this was better. No, this was perfect – a perfect Christmas for a Jew and his crazy friend.