Chapter 17: PPTH and Other Problems
"Why are you here?" Taub asked.
Pete looked around the lobby of PPTH: the kitsch masquerading as art, the plastic shrubs, the staff at the front desk pretending to be busy.
"It's like coming home," he said with false pathos, leaning over to take a sucker from the jar on the desk. The nurse on duty frowned at him. Tearing the wrapper off the sucker, Pete dropped it provocatively on the shiny tiles next to him, stuck the sucker in his mouth, and waggled the stick at the nurse by moving his jaw.
"Sure," Taub said equably. "What do you want?" Without waiting to see whether Pete was following him he strode towards the elevators.
"A new liver," Pete said around his sucker as he limped after Taub. He must have wrenched something in his remaining leg while lugging Wilson in and out of the car.
Taub stopped short, turned around and peered into Pete's eyes. "No signs of jaundice. Is there a problem with your liver values?" he asked in a neutral voice.
"Not for me, for Wilson," Pete elucidated.
"That – will be difficult," Taub said. "He only qualifies if he's been sober for the past six months."
Pete took the sucker out. It seemed that he didn't like the green ones. Perhaps the red ones were better. "Define 'sober'," he said, sticking the sucker into the plastic blossom of one of the potted plants and tipping his head to consider the effect.
"I amend my earlier statement; it'll be impossible," Taub said with no inflection.
"And I'll expand on mine: I don't want you to supply a liver, I want you to put the liver that I will supply into a liver-shaped hole in Wilson's body," Pete said, scanning the lobby for intelligent life forms.
Taub's expression grew more dour, as far as that was possible. "You realise that a liver isn't a silicon pad that you slip into the appropriate slot?"
"Yep. That's why I want an expert," Pete said. As though to underscore his words, the nearest elevator door opened and Chase walked out.
"Ah," Taub said. "For a moment I believed that you were here because of me."
"Do I have to choose?" Pete asked, sticking out his lower lip. "Can't I give both of you a rose?"
"Huh?" Chase said.
"Never mind," Taub said, rolling the two words into one. "I need to bleach my brain."
Chase looked from Taub to Pete and back again. Then he said, "Can we take whatever-this-is somewhere else? I've been on duty for thirty-six hours straight now, and I need a change of scene."
"Technically," Taub said, "this is my lunch break." He looked at the clock in the lobby. "Okay, make that my 'lunch-cum-dinner' break, so I guess I've got an hour. But then I have to be back here. Patient dying and all that, you know."
Chase, of course, knew just the place where Taub could get something to eat while he and Pete could get decent drinks.
"Drinks are on me," Pete said when they'd ordered (Chase: beer; he: beer to keep Chase company, Taub: soda and a sandwich).
Both men stared at him. "What do you want?" Taub finally said. "I mean, other than Chase performing an operation that is admittedly not routine, but for which he is the expert in the New Jersey area?"
Chase lifted an eyebrow. "I am?"
"Wilson needs a new liver," Taub explained to Chase.
"This wouldn't by any chance be connected to the cancer drugs you got from Cameron?" Chase asked.
Pete scratched over his stubble, which was getting uncomfortably long and itchy.
Chase leaned forward. "Neither of us is on the transplant committee. And before you ask, Cameron isn't either. She dropped out last year when Diagnostics expanded its capacity by twenty-five percent."
Neither piece of information was a major disappointment because he hadn't been banking on getting a new liver from PPTH.
"Can't Cuddy …?" Chase continued.
Pete cut in. "No one can get him anywhere near the top of a transplant list. But," he added, "I've got a live donor."
"That's … great," Taub said, making it sound like a question.
"You're not the 'live donor' by any chance, are you?" Chase asked.
Pete snorted. "Nope. Our blood types don't match." Not to mention that he didn't qualify for a live donation for any number of reasons, as Chase well knew.
Chase signalled to the bartender for another beer. "So what's the problem?"
There was more than one problem, but there was no need for Chase and Taub to hear about all of them. Lisa's staff, unhappy about the clandestine manner in which Wilson had arrived, were loath to get involved in anything that might get them hauled into an inquiry. It didn't help matters that Lisa was only an interim dean; leading staff members were using the period of uncertainty to stake claims or spin intrigues against their colleagues, with the net result that interdisciplinary cases such as Wilson's had all involved departments squabbling like fishmongers. The procedure was tricky not only from a medical but also from a moral perspective; chances were that hospital politics would screw up the little medical common sense that he'd seen so far.
But it wasn't his habit to volunteer more information than was strictly necessary, so he said, "Philadelphia Central isn't a transplant centre. The surgeons haven't got the experience to do a live transplant."
"You want the procedure to be done at PPTH?" Taub asked.
"No," Pete said. "Transporting Wilson isn't an option. I want you to do it at Philadelphia Central."
Chase leaned back, his expression quizzical. "You think we won't look as closely at your live donor as Cuddy's staff will. Sorry, House, but I know the guidelines and I'm not violating them. If your donor isn't in excellent health and aware of the risks, it's a no-go."
Pete pretended to a nonchalance that he didn't feel. "Don't worry, the donor will go through the hospital's clearing process."
"And I'm not removing more than sixty percent of his liver," Chase added, a challenging gleam in his eyes.
"Up to seventy percent is considered safe in healthy donors," Pete said.
"Sorry, not happening," Chase said. "I'm not endangering the donor in order to save Wilson."
Pete dropped his eyes to signify that he accepted Chase's decision. He doubted that any surgeon of Lisa's would agree to transplant more than sixty percent of the donor liver (if any of them were prepared to attempt the procedure at all), so it wasn't as though this was a major concession.
Chase, however, wasn't lulled into compliance. If anything, Pete's assent to his conditions seemed to have increased his suspicions. "And I want to talk to the donor before the procedure to ensure he is doing this of his own free will."
Pete pretended to be hurt. "Would I con or bully someone into agreeing to a transplant?" he asked.
Taub and Chase looked at each other. "Yes," they said in unison.
"Who's the lucky person?" Taub asked.
"I'm in contact with Wilson's family," Pete said vaguely. "One of his brothers is a potential donor."
"Oh, okay," Chase said, looking relieved. "We'll need privileges at Philadelphia Central, though."
"And leave from PPTH," Taub added.
Pete brushed that aside. "Lisa can wrangle both. Your boss won't refuse a request from a former dean involving a former head of oncology, not when it is couched in phrases like, 'PPTH's great expertise and universal renown in the area of transplants'."
"So," Chase asked, "what's the catch? Because there has to be a catch, otherwise you wouldn't have left Wilson for half a day just to ask us for something that you could have demanded from our boss."
His mouth twitched in approval. He'd have been disappointed in his former fellows if they hadn't smelled a rat. "Wilson was being stupid," he explained. "He didn't want to be admitted to hospital, so … ." He hesitated, scrunching up his face as he considered how to sell what had happened.
"So you drugged him and dragged him there," Chase concluded for him.
It was unnerving, the way that man practically anticipated his thought processes.
"What's to stop him from leaving?" Taub asked.
Pete grinned wryly. "Lisa's hospital has a policy that won't allow patients to be released AMA unless they can fend for themselves or can produce a caregiver."
"We still need his consent for a transplant," Chase pointed out.
"Not if he isn't in a state to express his wishes. Wilson has hepatic encephalopathy, which means he can't make his own decisions. Lisa is his medical proxy," Pete said, his voice heavy with meaning.
His former fellows looked at each other again. Chase raised his eyebrows questioningly at Taub, who pinched the bridge of his nose in quiet despair.
Chase played with his bottle. "What's in it for us?"
Pete leaned back, hiding his satisfaction. Chase wouldn't be bargaining if Pete hadn't managed to overcome his doubts and instinctive distrust of such a shady affair. Nevertheless, it wouldn't do to seem too keen to oblige him. "You mean, other than the satisfaction it gives you to help a former colleague and friend?" he said.
"Wilson was never a friend," Chase countered.
Taub looked consternated. "No?" he asked Chase.
"No," Chase, on his third beer now, said. "We turned to Wilson with House-related problems, not with our own."
Interesting. When planning the negotiation, Pete had assumed that Chase would help from a sense of moral obligation while Taub might need a financial incentive, but it seemed that the reverse was true.
"What do you want?" Pete asked. He disliked having to ask straight out; he'd have preferred to find out by himself so as to gain a strategical bargaining position, but chances were that the transplant would have to be performed within the next few days. There was no time to play head games with Chase.
Chase tugged at his collar. "I was thinking of switching jobs. PPTH is a dead end for me: the head of surgery is only ten years older than me and shows no intention of leaving PPTH."
"I don't think the head of surgery in Philadelphia is that much older," Pete said, frowning.
"No, but now that Cuddy is dean, maybe she'll be interested in opening up a diagnostic department at Philadelphia Central. Diagnostics was her baby when she was here."
Pete propped his chin on his hand, considering this. Lisa wasn't dean yet, and if he were given to gambling – come to think of it, he was – he wouldn't put his money on her. She'd just delivered a half-dead guy to the ICU under very shady circumstances, a guy who was due to have two very iffy procedures performed on him in the near future, procedures of such doubtful medical advisability that her surgical staff would mutiny if asked to do them (which was why he had no intention of trying to get their consent). Furthermore, if he didn't get a donor with an extra piece of liver soon, then he'd have to give the emotional thumbscrews that he'd put on Lisa another few turns, and he suffered from no illusions whatsoever as to what that would do to her career.
He shied away from that thought, focusing on the present. Chase couldn't know all this. But he could point this out to Chase; maybe he should point it out to Chase, considering that Chase was prepared to do him two major favours. Then again, Chase hadn't researched the person and the place that he was targeting, otherwise he'd know that Lisa wasn't dean yet. Maybe Chase wasn't so much interested in starting something new as in getting away from the old.
Pete's mood lightened. His bargaining position with respect to both of Wilson's pending operations could improve considerably depending on how badly Chase wanted (or needed) to get away from PPTH. Five percent more donor liver for Wilson could make a big difference in his present state and it would be nice, very nice indeed, if Chase re-sectioned Wilson's tumour even if the chemo treatment didn't shrink it as much as he'd assured Chase it would.
He tapped a happy rhythm on the table with the fingers of his free hand. "What better way to recommend yourself to Lisa than by saving Wilson's life for her?" he said, injecting a world of innuendo into the words.
Taub looked confounded. "Cuddy and Wilson are … an item?"
Pete opened his eyes wide. "Did I say they were?" he said.
"Are they?" Chase asked, eyeing him suspiciously.
"My lips are shut," Pete said, miming zipping up his lips.
"And – you're okay with that?" Taub asked.
"Okay with what?" Pete asked, purposely obtuse.
"With Cuddy and Wilson doing … whatever they're doing," Taub said, flapping his hands in a weak imitation of the kind of illustrative gesture that Wilson was fond of.
Pete weighed a packet of peanuts in his hand, estimating the number of nuts inside. If he got the number right, he'd eat the whole packet. If he didn't – he'd eat the packet anyway. Thirty-three peanuts, he decided. He looked up to find both men staring at him expectantly.
"Lisa Cuddy and I had a short history that ended badly, and before that a long history that ended …," he paused for effect, pretending to ponder his choice of words, "… even worse. How often do you think I have to repeat the experience in order to be cured?"
"Actually," Taub said, enunciating every word clearly, "I was referring more to you being okay with Wilson doing Cuddy than the other way round: I get that you and Cuddy are barely on talking terms. All the more reason for you to object to Wilson dating her."
Pete raised his eyebrows questioningly, so Taub added, "You don't like Wilson dating women who you don't like."
Chase snorted. "He doesn't like Wilson dating, period."
Pete tipped the contents of the peanut packet onto the table, mechanically grouping the nuts in fives to facilitate counting while he considered his response to the men's statements.
Their misconception was one he hadn't anticipated, because he saw Amy as the main hindrance to Wilson dating Lisa, not himself. But the fellows didn't know about Amy and her foetus, which was all the better, because it meant that he wouldn't have to explain her away. As for the rest, they were wrong on all counts: Lisa and he squabbled and fought and yelled and sulked, but it was a lot less awkward than the ice age that had reigned after he stumbled across his true identity at the PPTH anniversary gala. He didn't dislike her as such. As for Wilson, there was no harm in him getting laid as long as he didn't turn into one of those compulsive pleasers who spent all their time dancing attendance on their girlfriends. Lisa was too busy to block Wilson's schedule and Wilson wasn't crazy about her. If Wilson dated Lisa, nothing would change.
But regardless of whether he liked the idea of Wilson and Lisa dating, it was a necessary part of his stratagem that his former fellows believed in the possibility. "Wilson is practically living at Lisa's place, he's cooking for her, he's hanging out with her kid doing 'kiddy' things, he's celebrating Jewish festivals with them. He enjoys it while Lisa gets a dad for her runt and intelligent conversation at the dinner table. I'm not around much, so why should it bother me? If that's what they want, so be it."
Thirty-five. His estimate was off by two peanuts. He flicked a peanut at Chase, who was lost in deliberations of his own.
Taub looked unconvinced. "No matter how a guy feels towards his ex, he doesn't like to see other guys messing with her," he said.
"You'd know!" Chase muttered.
"Pot, meet kettle!" Taub countered. He turned back to Pete. "I don't know what game you guys are playing, but someone's going to get hurt again, and I don't like what you – any of you three – do when you get hurt. I want to be well outside your nuclear exclusion zone when you detonate."
"Relax," Pete said tiredly. "Until and unless Wilson survives, this is a hypothetical discussion, and the only thing that's detonating at the moment is Wilson's liver."
"What time frame are we talking about?" Taub asked.
"A few days," Pete replied. Chase whistled. "It's gotta be done, and the longer we wait, the weaker he'll get. A day, or maybe two, to get the donor liver, and then we're set to go." He looked at them expectantly.
Chase stared at him long and hard. Finally he said, "I'm on duty till Thursday. I'll have to get someone to take my shift."
Taub shrugged. "If it's for Wilson, Cameron will let me go."
Chase grimaced and got up, pulling his cell from his pocket. "Can we fix a day?" he asked.
"Day after tomorrow," Pete said, hoping Lisa wouldn't have a holy cow.
Chase nodded and went outside, presumably to call his boss.
When he was out of the door, Taub leaned forward. "I get that you want Chase in on this, but why do you want me? I'm a plastic surgeon, and I haven't assisted recently except during the occasional surgery that we have in diagnostics. I'm definitely not qualified to assist during an organ transplant, and bringing me in will piss Cuddy's staff off big time."
Pete looked at the door through which Chase had vanished. "You're there to ensure that Chase goes into the OT sober," he said.
Taub sighed. "I knew there was a major hitch."
Pete didn't quite meet his eyes. He didn't want to discuss Chase's problem, which wasn't his problem. Someone else was going to have to solve that one.
"I need to get back to the hospital," Taub said.
So do I, Pete thought. He settled the bill – Chase had drunk four beers in the hour they'd been there – and followed Taub outside. Chase was standing outside smoking; that explained why he'd gone out to make his phone calls. Pete held out his hand. Chase sighed, but gave him a cigarette and pulled out a lighter. Wrinkling his nose in disgust, Taub gave them a half-wave and set off towards PPTH.
"I've cleared the day after tomorrow. The rest is up to you," Chase said.
They smoked in companionable silence. "How's Wilson reacting to being drugged?" Chase finally asked.
Pete shrugged. "Badly. He'll get over it."
"Just like old times," Chase said.
Was it? "Were you drinking this much back then?" Pete asked.
Chase whistled in mock acknowledgment. "Interesting that you should bring it up just before I do a complicated medical procedure on your friend. I've got it under control, okay?"
That's what they all said. "You didn't answer my question."
"Is it your problem? When you were on Vicodin, I minded my own business."
"Oh, is that what they call 'enabling' nowadays?"
"Look, I know what I'm doing and you knew what you were doing. If you're looking for a scapegoat to blame for your addiction issues, then go look in a mirror."
Chase's cell rang. He took it out and looked at the caller ID, frowning when he saw who it was. "Hello?" he said. Pete sincerely hoped that if it was a surgical emergency at PPTH, it wouldn't require a steady hand.
But it wasn't PPTH. "It's for you," Chase said, proffering the phone. "Cuddy."
"Why aren't you taking your phone?" Lisa said without any preamble. "I tried to call you five times and I sent you about twelve messages."
Pete took out his own cell and checked. It was on silent mode. Oops! "Are you missing me, honey-buns?" he cooed into Chase's phone.
"Wilson is slipping into a coma."
She was sorting through the paperwork that she should have done this afternoon (instead of making lots of desperate phone calls trying to locate Pete) when he finally ambled into her office (without knocking, of course).
"When I couldn't reach you, I figured you might be with Wilson's brother, finalising the plans for the liver donation, so I phoned him. Guess what: Michael Wilson isn't prepared to donate. What's more, he says he told you so two weeks ago, and he'd be grateful if we stopped pestering him."
Pete didn't look particularly put out. Why should he? He'd probably known this all along. "He was a … a possibility," he said, with a flourish of his hands.
"Well, now he's a no-go," she said tartly. "Where were you?"
He sprawled on her couch. "Setting up a transplant team as I promised, oh Mighty One. "
Getting up and coming around her desk, she tossed Wilson's file onto the coffee table in front of him.
He sat up and picked the file up, taking his reading glasses out of his shirt pocket. His chin rested on his knuckles as his eyes darted up and down the columns of the latest blood panel. "A few days," he finally pronounced. "Maybe a week, then he's dead." He snapped the file shut. "Chase will do the transplant with Taub to assist him."
"What, without a donor liver?" she said, her voice heavy with sarcasm.
He looked up at her over the rims of his glasses. After what seemed a long silence he said, "You have blood group O, the same as Wilson."
Blood roared in her ears. She sat down suddenly on the edge of her desk, registering its sharp bite on the back of her thighs. "You – want me to donate?" she said in a voice that sounded very far away to her.
"No, I don't. I need you to donate. What I want is that some idiot wraps his motorcycle round the nearest lamppost while Wilson gets bumped to the top of the transplant list, but we don't always get what we want."
She rubbed her forehead, trying to get her thoughts sorted. "I can't do this. I've got commitments – Rachel, my job."
He sighed theatrically. "You're gonna let Wilson die because you don't want files piling up on your desk?"
Trust him to oversimplify matters and make them all black-and-white whenever it suited his purpose. "No," she snapped. "I'm making sure I won't die, because I have a daughter who needs me!"
He folded his glasses and replaced them in his shirt pocket. Then he rose with the swift grace that had always accompanied him, even when his leg had given him hell, and moved towards her. She instinctively drew herself up, knowing that he'd use every advantage he had – height, charisma, verbal aptitude, polemic, and knowledge of her weaknesses – to get his way.
He loomed over her. "You'll be happy to hear that a recent review of live liver donations showed that of one hundred donors, not a single one died. You'll be around to make Rachel's life a misery for as long as she'll let you."
"Why is it okay for Michael Wilson to opt out by citing his family obligations, but not for me?" she asked in a last-ditch effort to stave off the inevitable.
"How does he stand to benefit? He hasn't seen Wilson these past five years. He isn't the one who has had Wilson living in his apartment, celebrating Hanukkah with his family, pushing his kid's wheelchair and watching sappy musicals with her."
She swallowed hard. "How long will I have to stay in hospital?"
His eyes smiled, though his mouth hardly quirked. "A week. You'll have to take it easy for another six to eight weeks." He paused, his eyes narrowing to gauge her reaction, but she wasn't about to give him the satisfaction of freaking out at this. Two months of not being able to work one job, let alone the two she was doing at the moment! He had to know what that meant: she could take the deanship and stuff it up a dark, damp place.
"And no heavy lifting for three months," he added.
"Wha - what? You've got to be joking!"
"Are these lips smiling? Not more than 30 pounds."
"Pete, I have a wheelchair-bound child! I can't not lift her for three months."
He looked her up and down. "Since you're smaller than Wilson, they'll have to take the whole right lobe, so make that five months."
"Oh, wow, that makes the proposition so much more attractive!" She threw up her hands. "Seriously, Pete, how's that supposed to work?"
He shrugged. "Get someone to help you."
That was typical of him! He'd always refused to consider the day-to-day implications of his life-saving crusades – unless they impinged directly on his own well-being.
He seemed to sense her objections. "Come on, if you were the one who was dying, Rachel's life would also have to go on somehow."
This was something she'd rather not be reminded of. Besides, it wasn't the same. If she died, Julia would chip in and take Rachel, and she'd do a great job. But Julia wouldn't want to take Rachel for over eight weeks if she, Cuddy, decided to volunteer for a procedure at the bidding of a man who was to the Cuddy clan what Voldemort was to the wizarding world. Even if Julia was prepared to do so, it wouldn't be a good solution because Rachel would miss weeks and weeks of school. Pointing all this out to Pete, however, was a waste of time and energy. When he was on a roll mundane considerations such as these couldn't stop him.
So as she walked back to her phone, she merely said, "As my favourite philosopher used to say, 'Dying changes everything. Almost dying changes nothing.'"
He looked genuinely confused. "Who's that?"
"Never mind," she muttered. Perching on the edge of her desk again, she asked as she picked up the phone, "When do you want to do the transplant?"
"The day after tomorrow."
She dropped the receiver as though it was hot. "That'll never work. The procedure calls for a forty-eight hour period of consideration, during which the donor can retract their offer." The operation was a lengthy one – five hours at the best, more like ten if there were complications. If the operation was to take place the day after the next, it would be scheduled to begin in the morning, roughly in thirty-six hours. No matter who Pete bullied into donating, they were running out of time.
"That period can be shortened at the discretion of the physician in charge of the procedure if there is a close tie between donor and recipient."
"'Close tie' is defined as parent or spouse," Cuddy clarified. He was doubtless well informed, but she was chief administrator and knew how transplant committees interpreted the guidelines. "I'm neither."
"A spouse, or partner," Pete said.
"Wilson isn't my partner. … Oh, no, Pete! No one will believe that Wilson and I …"
Pete grimaced. "Actually, they believe it already."
Cuddy could feel a flush spreading upwards from her neck. "Why would they …?"
She cast her mind back over the past day. With Wilson refusing to speak to him, Pete had been at a loose end all morning, hanging around the hospital with nothing much to do until he'd scooted off to PPTH. She'd seen him from a distance a few times, hobnobbing with the nurses.
Pete didn't hobnob unless he had a reason.
"You spread the rumour, didn't you?" she said.
Pete's gaze flickered downward, then up again.
Rage bubbled up inside her. "You'd planned this all along, hadn't you? You knew your treatment would trash Wilson's liver, and you were banking on my liver right from the start!"
His eyes returned to her face. "You were Plan B," he said, "but I knew Plan A didn't stand much of a chance."
"It's easy for you," she fumed, "but for me it means re-organising my life and saying goodbye to the job I've worked towards for the past four years."
He followed her to the desk, his fingers absently sorting through the objects on it.
"Yeah, it's easy for me," he agreed gravely. "But it's easy for me either way. If Wilson dies, I go back to England, and after a few months my life will return to the way it was before I knew he existed. I'll know I did my best to save him, but that there was nothing more I could do. But you – you'll spend the rest of your life wondering whether you sacrificed your only friend on the altar of your ambition and your convenience."
He perched on the desk next to her, his arm a hair's breadth away from hers. The slightest tilt of her upper body, and she'd be leaning against him, if she so chose. She didn't; he was out of his comfort zone already, and forcing him to deal with her physical need for reassurance wouldn't get her anywhere. This was the closest he'd come of his own accord; expecting him to take her in his arm or pat her shoulder was pushing it.
He looked at her with compassion. "Wilson doesn't stand a chance of getting any other liver. Don't let your annoyance at my methods induce you to make a decision that you'll regret for the rest of your life."
A wave of fear washed over her. She looked down at her shoes so that he wouldn't see the panic in her eyes. "Okay," she said, keeping her voice low to mask the quaver in it. "Okay, I'll do it."
She couldn't see his face, but after a few seconds she heard him sigh. Then he pushed himself off the desk and went to the door, the unevenness in his gait so pronounced that she caught herself looking around for his cane.
She cleared her throat. "Pete?"
He stopped, one hand on the doorframe, and half-turned, his eyes avoiding hers.
"I consider you my friend too," she said.
He showed no visible reaction. After a moment he gave a minimalist nod and continued on his way.