Chapter 28.

I looked at Chase again. "Have you fallen for poor little Ellie?" I asked in a mocking voice. "She is still married you know."

"I know," Chase said, not really answering my question. "She's a nice person and going through a really rough time," he added.

"Most of our patients' family members do," I said, although I wondered about the 'nice' part. Actually many of them were quite annoying which is why I have my team deal with them.

"And I don't have much faith in the health of Ellie and Petey's relationship," Chase said, ignoring my comment.

"You'd take on a woman with a young kid, one who might need years of treatment?" I asked. I was as surprised as Chase that my mocking tone was gone.

But he wasn't interested in talking about it at that point. "Let's see what these hearing tests show."

Thirteen had been watching us volley back and forth and was finally ready to ask something. "Is hyperacusis hereditary?"

It was a valid question, one I hadn't really thought about. "I don't think there's any direct proof that hyperacusis is, but some of the causes, like Williams' Syndrome are. And it does occur in families, although no one knows why."

"So there's no particular chromosomal deficiency," she concluded.

"Again, not unless the cause is a genetic disease," I said, wondering how we were going to prove that the boy and his father had the same problem. Then I thought it might actually be cool if we were the ones to prove that hyperacusis is genetic. Well, we'd worry about that later. "Thirteen, go make sure Jess gets Petey to his appointment with Finnegan," I told her.

She nodded and left. I knew that Finnegan was one of those unimaginative doctors who just carried out the usual tests and procedures without thinking outside the box, but he was good at what he did and very thorough, so if there was something to find, he'd find it. We just had to sit back and wait.

Or not. I needed to do some research on the causes of hyperacusis. My memory had dredged up all that I'd told Chase and Thirteen, but I wasn't up on the latest findings on the problem. I also knew that Williams was another one of those genetic diseases without a known cure, and I was hoping it wasn't our answer.

As I'd thought, no one had yet proven a direct link between hyperacusis and any genetic abnormality. Besides Williams, the condition could be associated with autism, TMJ, Menieres, and Bell's palsy, but could also be triggered by long-term exposure to loud music, severe head trauma, and chronic ear infections. I seemed to remember that Christopher had a history of the later when he was younger. Had Petey suffered head trauma due to the accident? But then, the condition wouldn't have been passed on to his son, and wouldn't have shown up earlier in his life in the form of the 'spells' Jess had described. The case had been interesting before, and now it was becoming even more so.

I found only one article by researchers who had tried to prove a genetic factor, not so much for hyperacusis, but a tendency toward the syndrome. If they were right, it would account for father and son having different triggers. I reread the article three times. The doctors hadn't been able to prove what they were postulating, and they gave no indication of which chromosome or allele they were studying.

I was looking for any other similar reports when Jess entered my office alone. "The doctor is running his tests on Petey," she said. "I was going to go back to see Chris, but decided to come see what you'd been able to come up with."

"Aw, you missed me!" I joked.

She smiled. "That too."

I stared at her. She was serious. I hid my surprise by telling her what I'd come across, even though I wasn't sure she'd understand. Maybe I didn't care whether she did or not.

"So if there's some kind of genetic defect that both Petey and the baby have, it might be connected to a tendency toward this condition?" she asked, showing that she did understand. I'd forgotten how smart she was. "How do you find it?"

"Unfortunately, I'm not even sure where to look, and a complete genetic analysis takes a long time. There are some genes that have been typically found to be involved in similar problems, so I think we can start with those. I've already asked for an examination of the chromosomes that have been linked to other diseases."

"And how long will that take?" she asked.

"Hopefully not too long," I said, but seeing the concern in her eyes I added, "Jess, we're working as quickly as we can."

She nodded. "I know."

"I've been wondering how Petey could tolerate the noises at Universal if he has this problem," I said.

Jess shrugged. "Maybe he used the earplugs he had on the plane."

She was right. I'd seen him put them in before he walked back to coach, but hadn't thought anything of it. Lots of people used them to block out the constant drone of the jet engines. Another puzzle solved quite simply. I smiled. "Why don't you go see Christopher?" I suggested. "We haven't told Ellie any of what we're thinking right now, so avoid that, but you can reassure her that we're working hard on her son's case."

"Alright," she said. "Thanks, House. I know this case means a lot to you and that you'll do everything possible."

I watched her go, grateful that Ellie had someone like Jess as part of her support system. Ellie's parents had been to see the baby while I'd been gone, but they had to go back to their jobs, and her sister still hadn't shown up. I already knew that Petey wasn't going to be much help.

About an hour later, Thirteen came back with Petey's hearing test results. "Finnegan thinks that you're right," she said. "Petey's reaction to sounds at various decibels indicated hyperacusis."

"Where is he now?" I asked.

"Chase took him back to the baby's room," she reported. "Can we tell Ellie what we found and what we suspect?"

I considered it for a while, then stood. "I'll tell her."

We found Christopher's room crowded. His parents were glaring at each other, Jess was trying to play peacemaker, and Chase was tending to the baby. They all looked my way when I entered with Thirteen right behind me.

"You want the good news or the bad news first?" I asked to really get their attention. I didn't wait for anyone to answer. "Petey, there IS something wrong with your hearing. You have hyperacusis, which is a heightened response to sound. Don't know yet what caused it." I'd ask about the car accident later, but it wasn't that important right now. "It's possible the same thing's wrong with Christopher, although as Thirteen pointed out, it's not strictly hereditary."

"If that's what's wrong, what can you do for Chris?" Ellie asked.

"Don't you care that Petey has the same problem?" I asked.

"Well, I guess," she said.

"It'll depend on the cause, but the condition has been successfully managed using pink noise generators, or the earplugs that Petey's been using all along." I looked at him accusingly. How he could claim that he didn't have a hearing problem when he relied on the things was beyond me. "The test they do on the baby later today will confirm whether that's his malady."

"But how can something as simple as that make him so inattentive?" Ellie asked.

"He's just automatically using everything he can to block out any noise, any sound that disturbs him," I explained.

"So what's the good news?" Petey asked.

I rolled my eyes. What an idiot!

"Petey, the good news is that the doctors now think they know what's wrong with your son," Jess explained.

"Oh," he said.

I rolled my eyes again.