Chapter 15: Chapter 15

A/N: Here goes. Thank you everyone for your reviews and for adding me to your alerts/favorites. I am honored you like my story!

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It was late Saturday afternoon as House entered the Diagnostics conference room to meet with his team. He hadn't expected to be called in but they had a case. He jumped at the opportunity because he didn't necessarily like being home alone too often, even if it was a Saturday. He threw copies of the file on the table and began.

"Seventy-seven year old male with painful swelling and dysfunction of the right knee, complaining of persistent right knee pain for the last two months."

Chase was the first. "Is there any traumatic injury to the knee?"

"None. I'm thinking degenerative meniscus lesion? We could do an MRI" said Adams.

Park looking through the file chimed in. "We can't do that. He's got a pacemaker, can't do an MRI!"

"What about intra-articular steroid injections?" asked Adams

"Last physician tried that, it didn't work", said House.

Taub replied, "I say we try an arthroscopic partial medial and lateral meniscectomy and see what happens."

"Small fry wins. Go with it." With that House went into his office and closed the door.

Park asked, "What's up with him?"

The team just shrugged their shoulders and proceeded to go run tests on their patient.

In the meantime House limped into his office and sat at his desk with his red mug filled with hot coffee. He rubbed his right thigh which had been hurting a little more than usual the last few days. He hadn't said anything to Wilson because he didn't want Wilson smothering him with questions and concern. He knew he should tell Wilson because one of the things Nolan was adamant about in therapy was that House needed to trust others and open up to them. Nolan had told House that those closest to him should know his struggles so they can support him. Wilson could not be a good support system if he didn't know what House needed yet Wilson was a born caretaker and he didn't know when to quit nagging House.

There were times when the pain was so intense that House wondered if the physical therapy and exercise were doing any good. Fortunately these bad days were much fewer than they used to be, thanks in large part to a better pain management routine and his physical therapy, but when they hit, they hit hard. On those days it took everything he had not to seek Vicodin as the remedy for his pain. No one except Nolan and his physical therapist really understood how difficult it was for him during those moments. He wondered if one of the reasons he didn't let on to Wilson how bad it was at times is because he remembered the times in the past when Wilson dismissed his pain, saying it was in his head. House knew that he was an emotional wreck back then but he had also experienced real pain Wilson had never had to deal with and House hoped he never would.

House knew Wilson was right, that emotional pain could sometimes contribute to physical pain, though he'd never admit it to him. He'd been thinking a lot about Cuddy lately and realized the pain seemed slightly more intense during those moments. He was really worried what she thought about what he had written to her, it weighed heavily on his mind. He never expected her to rush back into his arms, but he had hoped she would someday forgive him. The weight of what he had done to her weighed heavily on his mind. The thought that she might not forgive him suddenly sent him into panic mode. His chest felt tight and he couldn't breathe. He jumped out of his chair and limped out to the balcony where he held on to the stone wall, closed his eyes and took a deep breath, which calmed him immediately. He remembered something Nolan had told him in therapy.

"You are the only one living your life and you have to take charge of it, don't let it take charge of you. If you want to be less miserable, then you have to do it for you, not someone else. The only person who can change your life is you."

House thought about those words and wondered if he could actually ever be happy, or at least less miserable. He'd felt less miserable in the last year but he felt empty. He had his job and his friendship with Wilson but he didn't really have anything else. He was lonely and he didn't know what to do about it. He no longer spent long hours at the bars, he didn't call hookers to his apartment anymore, and he tried not to spend too many hours brooding in his apartment and drinking. He recalled the time he spent with Cuddy, was mostly at her house and it was never boring. He had even enjoyed spending time with Rachel once he got used to her. He liked that she was so curious and asked so many questions. He remembered telling Cuddy that when Rachel got old enough they should buy her a microscope. He chuckled at that thought. He wasn't sure when he and Cuddy had become they but he liked it. He never thought he would miss being with someone so much and he never thought a day would come when he hated spending so much time by himself. He was beginning to second guess his idea that people don't change.

He was taken by surprise when Chase walked out onto the balcony.

"How's the patient?" he asked.

Chase replied, "Taub and Adams are with him. He's in more pain, developed soft tissue swelling, skin color change and hyperhidrosis. Right knee shows vasomotor and sudomotor changes. Active and passive range of motion is painfully limited."

"What else?"

"Tenderness on palpation of the medial femoral condyle. Ligamentous stability and meniscal integrity cannot be examined due to the pain."

"Are we thinking CRPS?

"Complex regional pain syndrome is a possibility."

"Go with it. Take some blood samples and do a CT/bone scan to confirm."

"Okay." Chase walked away then turned around. "House?"

"Yeah?"

"You okay?"

"Why wouldn't I be?"

"You seem quiet."

"When I'm raising hell they complain. When I'm not raising hell they complain. Can't get a break can I? Go on, get out of here, let me know when we've cured him."

Chase shrugged his shoulders and left. Despite the fact his boss could be a real pain in the ass, Chase liked House. They endured a rocky relationship at times over the years but he'd come to really respect House and he felt House respected him. Working with House so long, he'd learned to read his moods. He could sense when there was something on House's mind but House wasn't one to talk about his problems, at least not to his team. Chase had seen the positive changes House had made since being back at the hospital and he hoped his boss would continue to improve.

House stood on the balcony and looked over the grounds of Princeton-Plainsboro. He remembered another time he was standing on that balcony. It was a Friday evening right around dusk. He had gone out to his balcony to get some badly needed fresh air after having been cooped up for days inside the hospital trying to solve a complex case. Suddenly, he heard a familiar voice behind him.

"Hey."

House turned around and saw Cuddy walking through his office to join him on the balcony. "Hey yourself."

"Why are you still here? Case is solved."

"I'm too tired to do anything else." He sighed, closed his eyes and dropped his head forward.

Cuddy placed her hand on his arm gently, "Want me to drive you home? Order some dinner, take a nice hot shower. Relax."

House perked up a bit. "Shower first?"

Cuddy smirked, "Maybe, but only if Rachel's in bed."

"You're such a tease. You know the little monkey has to learn the birds and bees some time."

"House! I don't want her to catch us having sex."

"She might learn something. I am the master you know."

Cuddy smacked House on the arm and he motioned for her to move closer to him. They wrapped their arms around one another. He closed his eyes and smiled. He never tired of the feeling of being near her, close to her in moments like this when everything was just right. He buried his nose in her curls and inhaled deeply. Her hair smelled like vanilla. Her scent always calmed him and sent a feeling of warmth through his body. He pulled her tightly to him and just stood there holding her.

Cuddy sensed something was up. Without breaking the embrace, she asked, "Are you okay?"

"I'm fine."

"You sure?"

"Shhh. Just relax."

Cuddy enjoyed these moments as much as House. It was so rare for him to give such an openly warm public display of affection but she absolutely loved when he did. As they stood there, at dusk on the balcony outside his office holding each other, he whispered in her ear.

"I love you."

Cuddy opened her eyes in surprise at his sudden revelation. She knew he loved her but he hardly ever said those words because he believed actions were more important than words. His method was to show her, albeit through the most unusual and sometimes obscene ways that he loved her. She knew when he said it, there was no doubt in his words. She looked up at him and smiled. "I love you too House."

He dropped his arms a bit and squeezed her ass cheeks. She grinned up at him and said "Come on grumpy, mama's driving you home."

"You know I wouldn't be so grumpy if you put out at work."

"House!" she smacked him again.

"Hey that's abuse! I'm calling the cops."

"Ha! Maybe you should call child protective services instead?"

"Nice. Are you implying that I'm a child?"

"If the shoe fits."

"Well then, cradle robber, why don't we go back to your place and find out if this child has what it takes to make mama happy?"

"You're on." They laughed and walked back into his office, he stuffed his backpack with his iPod, files and other things, grabbed his cane and they walked out together, hand in hand.

House smiled remembering that moment. He still wondered at times how he got there from here. He still couldn't grasp how one minute he could be so in love and happy, at least his version of happy and the next minute he was sinking into the depths of hell. It's one of the things he and Nolan tried to work through. House knew his life had to change, but there was no way he could change without figuring out how to deal with his screwed up past. His past helped make him who he was and he was determined that no longer would he let the ghosts of days gone by run his life. At that moment, he just felt like he needed to talk to Nolan. He walked back into his office to get his cell phone when Adams arrived.

"Thought you were curing our patient?"

"I was."

"Not if you're here. What's going on?"

Adams took a deep breath. "It's not CRPS."

"How do you know?"

"The lab results and scans were conclusive. It looks like metastatic urothelial carcinoma."

"What about the CT?"

"CT showed some nonspecific trabecular changes in the medial and lateral femoral condyle."

"Did you do a triple phase bone scan?"

"Yes. It revealed increased activity inflow with the distal femoral diaphysis and epiphysis during the perfusion stage. During the second and third phase of the bone scan, multiple enhancements in the distal femur, the right tibia and right hemipelvis were detected."

House finished it for her. "Which means a metastatic process caused the pain, swelling and dysfunction. Do a biopsy of the femur and cystoscopy to confirm. Then call Wilson for a consult."

As Adams turned around and left, House banged his cane on the desk. He knew what the tests would confirm, it was indeed metastatic urothelial carcinoma. Considering the length of time the patient had dealt with this illness, the tumor had likely progressed past the point of no return. It wasn't entirely the patient's fault, CRPS symptoms were mimicking the disease so it was a perfect scenario for misdiagnosis. The best they could do for him now was palliative chemotherapy. He probably had two weeks at best. House signed. He hated losing a patient. But he and his team had done everything they could.

He reached for his phone and dialed a number.

"Hey Nolan."

A surprised Nolan greeted House on the other end. Usually his patient only called him if something was wrong. "Are you okay Greg?"

House sat down at his desk. "Lost a patient, or rather we're losing him now. Not much we can do but help with his pain."

"How long?"

"Maybe two weeks, that's being generous."

"I'm sorry Greg."

"Nothing to be sorry about. We did what we could."

"I know but you take your cases seriously and you hate losing a patient. You care."

"No I don't."

"Okay fine. You don't. But still it bothers you that this man is dying."

"He's seventy-seven years old, he's lived a long life."

"Losing a patient is never easy. It's a life Greg."

House was silent. Out of the blue he asked, "Have you ever lost a patient?"

That question surprised Nolan but he decided to answer it. "Yes."

"What? Did you talk him to death?"

"No. He committed suicide."

House was silent.

"Greg?"

"I'm sorry."

"For what? There was nothing I could do."

"Oh come on you had to feel guilty. It's your job to read patients." House wasn't trying to be mean, he was just hoping to deflect from the awkwardness of the moment.

"At first I did. I felt responsible because I should have seen the signs. As his physician I should have known. But honestly, I never saw it coming. He seemed to be making great strides and then one day something snapped. There was no way to know he would do this. Trust me, I looked at his case a hundred different ways and in the end I realized suicide was his choice and I had nothing to do with it."

House didn't know what to say. He thought about all of the times he'd nearly gone over the edge, come so close to death.

"Greg? Are you there?"

House snapped back into the moment. "Yeah, sorry, just thinking."

"What are you thinking about?"

House wasn't sure if he should reveal but this was Nolan and the promise had been no secrets if Nolan was going to help him with his therapy again.

"I was thinking about the few times I actually wanted to die, or I thought I did, but really I didn't."

"What were you thinking during those moments?"

"I hurt and I didn't know how to fix it."

"Physically or emotionally?"

"Both."

"Do you still feel that way?"

"No."

"That's progress."

"I guess."

"House, you called me for a reason. What was it?"

House was quiet for a moment then said, "My leg hurts."

"Are you doing anything for it?"

"I'm sticking with the regimen if that's what you're wondering. Yes I want Vicodin, no I won't go near it."

"Good job Greg. I know how hard this is for you."

"Some days are worse than others. Most of the time it's actually bearable. But the last few days it comes and goes. When it hits though it hurts like hell."

"I know you have therapy on Tuesdays after you see me, have you thought of maybe getting an extra session in early?"

"I was thinking maybe a hot tub and massage this weekend."

"Great idea. Did you stand on your leg too long? Has something happened to make it hurt worse?"

House expected that question. "Been sleeping at the office the past few days because of this case. Haven't been able to really sleep comfortably."

"That might have something to do with it. Anything else?"

"Are you trying to get inside my head?"

"Well it is what I do best."

House thought for a moment, should he tell Nolan how much he'd been thinking about Cuddy?

"I've been thinking about Cuddy lately."

"That's understandable, you're working through all your issues and Dr. Cuddy was a major part of your life for many years."

"Yeah. Sometimes it will flare up when I think too much about her, about us, and everything..."

"That's all part of healing and getting your life together. I want you to listen to me, your pain is real. You are missing a large chunk of thigh muscle. Don't let anyone try to convince you that this is all in your head."

"Gee, would you hold that thought while I go get Wilson on the phone?"

"Dr. Wilson thinks it's all in your head?"

"Not all of it, but most."

"Greg, don't worry about what he says. You know your body, you know your leg better than anyone else. If you tell me it hurts I believe it."

House thought for a moment. "There's more isn't there?"

"Well yes."

"I knew it. Spill."

"There is no doubt in my mind the pain you are experiencing is real. However...there are times that stress can exacerbate that pain and make it just a bit worse. So please understand I know your physical pain is real, I also know that it can be made worse by the things you're enduring emotionally."

"I know. I appreciate your honesty. Thanks for not dismissing it."

"Is Dr. Wilson really that bad?"

"No. He's my best friend, he's trying to help. But he doesn't understand this kind of physical pain and he doesn't know my mind like you do, hell I don't even know if I know my mind like you do. He's doing the best he can do to support me and I appreciate it. I should probably go easier on him I suppose."

"Don't be afraid to be honest with him. He really is trying to help, he's just not sure how."

"Yeah I guess."

"Greg, are you okay? Is there anything else you wanted to talk about?"

"I think I'm good, sorry to have bothered you."

"Greg, you're not bothering me. I'm actually glad you called. I'm glad that you know that you can come to me anytime. Took us a while to get there the first time around and it was important that we establish that trust again. I care about what happens to you."

"Oh God don't go all soft on me."

"Hardly. But you've gone through life thinking people don't care what happens to you, and I'm telling you that you're wrong. People do care. You just spent years shutting them out because you were afraid of the rejection you would feel if you reached out and they didn't reciprocate. You were afraid to trust anyone. Things are different now, you are different. You can do this."

House thought for a moment about what Nolan had just said to him. He'd thought of throwing some sarcasm out there but instead he just uttered, "Thanks."

"I'll see you Tuesday right?"

"Yeah. Tuesday."

"Okay Greg, enjoy your weekend. If you need anything please don't hesitate to call me."

"I will, thanks" and with that they hung up. House took a deep breath. He actually felt relieved. He packed up his things, grabbed his cane and headed towards the elevator. As he did, he noticed the pain in his thigh was slightly less intense than it had been over the last two days. That son of a bitch. He knew what he was doing. House smirked as he walked out of the hospital, climbed on his bike and headed home. There was a bathtub and a nice warm bed waiting for him and there was nothing he wanted more right now than a hot soothing bath and a good night's sleep.

At that moment, in Philadelphia, a psychiatrist was sitting in his favorite chair in the living room of his home which was warmed by a roaring fire. His feet were propped up on the leather ottoman, he had a book resting on his lap, a glass of brandy on the table next to him and Dizzy Gillespie was playing in the background. He had a smile on his face and let out a slight chuckle. To no one in particular, Nolan said aloud, "Good for you Greg, good for you" and he went back to reading his book.

Well there goes, yet another chapter. I really liked this one because I wanted to include scenes from the workplace and also more Nolan. When House returned to Nolan after quitting therapy the first time, he and Nolan had made a promise to see this through. So it's important that when he feels he can't talk to anyone else, that he talk to Nolan.

As always, please leave a note on your way out! :) Jess