Chapter 4: A Second Opinion

The next morning, Wilson had several meetings and immediately after, had back-to-back appointments with patients. He didn't have a break until 11:30, when he went looking for House. He found the diagnostics team in their conference room, but they hadn't seen their boss all morning. He checked all of House's usual hiding places – coma guy's room, the oncology doctor's lounge, the obstetrics call room, and the ER waiting room. No House. He was passing the clinic when he saw Cuddy. "Have you seen House?"

"No. Should I be worried that he's up to something?"

"No, I was just trying to find him for," Wilson paused, "a consult."

Cuddy didn't believe him, but let it slide. Wilson looked even worse than he had yesterday.

"He was here for his clinic hours this morning," supplied the desk nurse helpfully. "He left at 10:30 when his shift was done."

Wilson contemplated revisiting all of the usual hiding spots, but decided that if House didn't want to be found, he wouldn't be. He went back to his office and tried to concentrate on reviewing charts.

At that moment, House was in the medical reference library located in the hospital basement. At the scowl on his face, the medical student abandoned the computer terminal and the librarian decided to ignore the fact that he was eating crackers, clearly in defiance of the 'no food or drinks allowed' sign. Even in this distant corner of the hospital, House's reputation had proceeded him.

Eventually he was surrounded by papers and open reference books. He looked at his watch; General Hospital was about to begin. He shoved the papers into his backpack and limped to the door.

"Dr. House, is it all right if I re-shelve the books?" the librarian managed to ask.

"Whatever," he replied. None of them had provided the answers he needed. He made his way up to the obstetrics call room, where there were comfy chairs and a plasma screen TV. Obviously there's good money in delivering babies. He figured it was a pretty safe hideout, because he hadn't used it in several months.

Fortunately, the room was unoccupied when he arrived, and he sank into a chair as the opening credits to General Hospital were about to roll. The show was almost over when someone entered. It was Barry Coleman, one of the few doctors that had been amused, rather than upset, with House invading their space.

Without speaking, he sank into the chair next to House, and they both stared at the TV screen. "I thought she was dating that other guy, the one with the blond hair."

"That was months ago, before she realized she was carrying Ryan's baby. Now she's sleeping with his brother."

Barry shook his head; it was too complicated to keep straight. He only watched the show when he was feeling stressed. They watched until it was over, when House asked, "in your profession, how many abdominal ultrasounds do you think you've looked at?"

"I don't know. Thousands, I guess." His mouth quirked into a smile. "I'm not like McDonalds, with a sign over my head reading 'over 3,000 served'."

"So you've seen some odd things, right?"

Barry grinned, "I specialize in high risk pregnancies. If it's weird, it's probably crossed my desk. Why?"

"It's just…" House paused. "There's this ultrasound that makes no sense. I need a second opinion."

"You have the film?"

"No. This one needs to be done in person."

"Can she get in this afternoon? Mrs. Garvey isn't going to deliver for a few hours and the floor is fairly quiet today."

House pulled out his phone and turned it on. Immediately he saw the message – eleven missed calls. He dialed a number from memory. "Hey, it's me." For a minute he only listed to the voice on the other end of the line. He sighed. "Can you meet me in about ten minutes?" He looked up at Barry. "Where?"

He repeated the room number to the person on the phone and hung up. Five minutes later they were in the OB exam room when Wilson walked in, looking surprised at the third occupant of the room. "House? What's going on?"

"Second opinion," was the reply.

Barry was confused. "I thought your patient was meeting us here?"

By that time House had loosened his belt and had climbed up onto the exam table. "Nope. I'm it. Go on Wilson, show him. Maybe he'll have some idea what the hell that thing is."

House laid back as Wilson applied the gel and picked up the ultrasound wand. Almost immediately he found it. House sighed; so much for the hope that it had been some kind of hallucination. Damn.

Barry shrugged and looked at the ultrasound. "What the hell?" He looked closer. "That looks like a…" He couldn't even bring himself to finish the sentence, it was so absurd. Now Barry knew why House had asked for his help. He took over the ultrasound wand, and the room was silent as he moved it across House's belly, trying to visualize the major organs of the abdomen. It had been years since he had examined a male patient, but everything looked normal, except for that one thing. "Obviously it isn't what it looks like. There's no way it's a baby."

House sat up, and his voice was angry. "Fine. Great. It's not a baby. According to Wilson it's not a tumor. According to you it isn't a baby." He was almost shouting now. "I don't want to hear about what it isn't. I want to know what it is!"

"Parasite?" Barry suggested.

"So how many times have you told someone with a parasite to expect a little bundle of joy in a few months?" House replied.

"Never. Parasites usually aren't mistaken for babies."

"Fine. But what if you weren't sure? How can you tell the difference?" House asked.

"Most obvious would be a pregnancy test. Parasites wouldn't cause an increase in," he took the paper House handed him, "beta-hCG levels." His voice trailed off as he read the numbers. "You're not pregnant. This just means you've got…"

"Testicular cancer?" supplied House. "Head of oncology doesn't think so."

"That's the only possibility!" Barry snapped back.

"Ultrasound might suggest otherwise," House replied, before his shoulders sagged and all fight seemed to leave him. "I just want to know what the hell is wrong with me," he whispered, and for a moment, Barry could see the fear lurking in his eyes.

"Why don't we go back to my office and discuss this. I'm sure the nurses are starting to wonder what three male doctors are doing in here without a patient."

House wiped the gel off of his stomach and slid off of the exam table. As they made their way to Barry's office, he heard the obstetrician murmur to one of the nurses, "I guess our patient chickened out on us."

When they entered the office, Wilson's eyes fell on the whiteboard occupying one of the walls. "You mind if I get rid of some of the drawings?" he asked.

"Sure, my kids will replace them next time they visit," Barry replied.

As Wilson erased the board, House slumped in one of the chairs, propping his right leg on a trashcan as a makeshift footrest. He watched as Wilson drew three columns on the board and labeled them: cancer, parasites, pregnancy. Wilson turned around, somewhat enjoying being the master of the whiteboard for once. "OK. We have three potential diagnosis."

"Hello! Aren't you forgetting that I have a dick, which would clearly rule out the third possibility. Jimmy, you of all people can attest to the fact that I am a dude."

Wilson turned a bit red, but otherwise ignored House; it was usually a bad sign when House started to call him by his hated childhood nickname. "Now we will all agree that each diagnosis is somewhat problematic." House snorted, but didn't interrupt again. "I know each has at least one strike against it, but at this time these are the best we've got. I think that each one of us should take one of the possibilities and come up with any test that could prove or disprove his diagnosis. I'll take cancer, Barry pregnancy, which leaves House with parasites."

"You don't actually think Barry is going to succeed, do you?"

"Not really. In fact, all three will probably be disproven, but sometimes there's a lot of information in a negative result. How about we make this more interesting -- $500 to the winner?" Barry looked shocked, that they would bet on something like this, but eventually nodded when he saw House agreeing as well.

They worked in silence for a while, every once in a while one of them moving to write a new test on the board. It was when House was finished with his own relatively short list that he began reading the other lists. His jaw dropped when he read the last item on Wilson's list. "Sperm count!!! Are you trying to help Barry by proving I'm not really a man?"

"No. It's just a fairly low tech way of seeing how your testicles are functioning. Any idiot with a microscope can do it. I may even run it myself."

"You going to collect the sample as well?" House asked.

Again, Wilson turned bright red as he opened and closed his mouth a few times, no words emerging, while Barry ignored the second somewhat suggestive comment of the afternoon. House ignored the effect of his words and continued to scan the lists on the board, moving on to Barry's list. "A few blood tests are fine, but someone is going to notice if we use the MRI."

Wilson looked at his watch. "Let me see what I can do. I hope she's still in her office." He dialed a number. "Dr. Cuddy. This is James Wilson. Are you going to be in your office for the next few minute? OK, great. I'll be down soon." He hung up the phone. "Start writing up lab slips." He looked up from his writing to see the wariness in House's eyes. "Don't worry. She agreed to no questions asked." House sighed and nodded.

When Wilson arrived in Cuddy's office, she didn't even look at the lab slips before signing them. At the request for the MRI, she looked thoughtfully at him, but didn't ask any questions.

When he returned to Barry's office, he found that Barry had done the blood draw and House was off collecting the other samples. When they were all together in the office again, Wilson had some news. "I called radiology and they were able to get us in at 7 PM. Barry, will you be able to do the MRI yourself? I think it's best if we let the radiology tech have a break."

Barry nodded. "No problem."

As they waited for their MRI appointment, Barry began taking House's medical history. Wilson listened in as House described the nausea, vomiting and other symptoms. He was surprised to hear how certain foods increased the nausea: seafood, coffee and alcohol.

"Alcohol? I haven't seen you drink in almost two months."

"That would be last night when I attempted to get drunk. One swallow and I was puking my brains out."

At 7 PM, they were all down in the MRI room. Wilson disposed of the radiology tech with a $50 bribe, and handed over House's pager. "We'll page you when we're done." She was a little leery about leaving, but in the end decided that it must be OK since the Dean of Medicine had personally signed off on the orders. As Barry began setting up the scan parameters, Wilson helped Greg onto the table. When he arrived in the booth, Barry was ready. "OK House, we're ready to begin."

As the machine began the whirring and clunking noises that accompanied the scans, House closed his eyes and tried to forget all of the other times he had been trapped in this modern day torture device. Scans that had always revealed bad news, and he had a feeling that this time would be no different.

Inside the booth, the obstetrician and the oncologist were looking at the images as they came up on the screen. Barry was staring intently at the screen, before he typed in a few commands to modify the scan.

When the revised scan was completed, the machine stopped, and over the intercom they heard House grumble, "OK guys. I know you probably think that this is funny, but can you please get me out of this coffin?"

Barry leaned over to talk into the microphone. "I need you to sit tight. I want to run another scan with T2-weighting."

"Fine. Whatever."

When the scan was done, House went to put on his clothes, and Wilson and Barry paged the tech. They downloaded the scan file onto a disk and then deleted the file. They went back to Barry's office where they looked at the MRI results. When the lab results arrived, they adjourned to the diagnostics conference room, which had more table space and was currently free of House's underlings. Wilson took the stack of computer printouts, and like a Vegas blackjack dealer, passed each sheet to the doctor who had requested the test. For a long time, no words were spoken, except for the occasional request for a piece of paper, which was silently handed over.

TBC

Another reference:

Deborah Levine (Ed.) Atlas of Fetal MRI, Taylor & Francis, Boca Raton, 2005.