บท 84: Chapter 84
Well, with the end of the final exam season and probably due to all the lack of sleep and poor eating habits, I'm quite sick.
Fortunately, I have a couple of chapters prepared. I have to admit one thing though: this chapter and the last one were one chapter, but I split them into two. That's why they are 'shorter' 3k each.
PS: 199 hearts on my profile, I've never felt so much love
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It didn't take me long to discover where House and the rest of the team were—in one of the private rooms, around the patient lying in bed and next to a visibly upset strange woman.
House, at the head of the patient's bed, was ventilating with a resuscitation bag, completely serious.
Of course, he had ignored the DNR; it didn't surprise me at all.
At that moment, from the other side of the hallway, a group of nurses and technicians were pushing one of the hospital's mechanical ventilators.
"Ah, finally, and look who's here. I thought the aliens had abducted you," House declared upon seeing the nurses and technicians enter with the machine, adding the rest when he saw me behind them.
"They actually did," I sarcastically murmured as I entered the room.
"I'm sorry, who's this?" the strange woman, who was visibly furious, asked.
"PJ Duncan," I said, smiling uncomfortably, introducing myself. On second thought, I didn't want to be there at that moment.
"Now that we all know each other, the IVIG made him worse, why?" House asked.
"Unbelievable," the furious blonde woman murmured, leaving the room with her phone in hand.
"Means multifocal motor neuropathy was a bad diagnosis," I replied, glancing at the woman walking out of everyone's sight.
"Doctor House," raising his voice momentarily, Dr. Foreman said angrily, "do you think this is a good place to discuss this right now?" he asked with forced calmness in his tone.
"Well, I don't think he cares right now," House sarcastically responded, pointing to the unconscious patient in the bed, "but if it makes you feel better, we can step out," he added mockingly, shrugging.
"I would like that, yes," Dr. Foreman immediately said, walking out of the room. House and I followed him, while Chase and Cameron stayed behind to supervise the installation of the mechanical ventilator.
Outside the room, contrary to Dr. Foreman's recommendation, we simply stood in silence, waiting for the machine to be installed.
Dr. Foreman, who was a few steps away from us, was pacing back and forth, looking like he was about to explode, obviously furious. House, meanwhile, seemed simply lost in his thoughts.
"So… what's the legal defense?" I asked House in a murmur, uncomfortable with the silence, "the patient's capacity to make the decision?"
I had seen the numbers in the studies, and the patient's thyroid levels were slightly low, but not enough to be a real legal concern.
"Yup," House said easily, nodding.
"That's only going to work for so long," tilting my head slightly, I muttered, not entirely sure of my own words.
"Let's hope it's enough time to figure out what's wrong with him," House responded seriously, looking at the patient's room, completely calm about having assaulted a patient with a DNR.
The nurses and technicians who handled the ventilator installation left the room once their work was done, while Chase and Cameron stayed behind, checking the levels shown by the machines.
"Come on, we have work to do," House said, starting to walk toward the lounge once Cameron and Chase finished whatever they were doing in the room. The rest of the doctors followed us, including the still visibly furious Dr. Foreman.
"He's stable on the ventilator, oxygenating well," Chase said as we entered the diagnostic lounge.
Diane was sitting in one of the corners of the room, directly next to the entrance door, reading a book quietly.
House, walking in front of everyone, turned on his heels to face us. I could see his eyes briefly glance at where Diane was sitting silently, but without commenting, he ended his gaze on me with some suspicion. "What's really wrong with him?" House asked, as if there was nothing unusual in the lounge.
"What's wrong with you?" Dr. Foreman, finally exploding in the 'privacy' of the diagnostic lounge, asked, raising his voice, obviously angry.
"Everyone knows what's wrong with me," House declared, tilting his head with a mocking smile on his face, "what's wrong with him is more interesting."
"You tubed him, and he didn't want to be tubed," Dr. Foreman immediately responded, clenching his jaw, "he has a legal paper saying just that."
"To intubate or not to intubate," House declared theatrically, "that is the big ethical question," he added a moment later, raising one of his eyebrows, "actually, I was hoping we could avoid it and maybe just practice some medicine."
"There is no question, it's the patient's decision," Foreman said, frustrated.
"If the patient is competent to make it," House declared tentatively, shrugging, "if his thyroid numbers aren't making him sad."
"Oh, my God," Dr. Foreman said, exasperated, "you don't believe that."
"His thyroid levels were a little—" Cameron was trying to say, but Dr. Foreman immediately interrupted her.
"It's nothing, and do not defend him!" the angry doctor warned her.
"Why did he sign that DNR?" House asked, staring at Dr. Foreman.
"I-I didn't talk him into—" Dr. Foreman, taken by surprise by House's sudden question, was trying to say.
"No," House interrupted forcefully, "he signed the DNR because he didn't want a slow, painful death from ALS," House continued seriously.
I hadn't met the patient, but if the extensive history of clinical tests was any proof, John Henry Giles surely wanted to keep fighting to get his life back. If there was real hope in his case, he probably wouldn't have signed a DNR.
"What was happening had nothing to do with his ALS," House continued, proving his point.
"Exactly! It's the IVIG, you screwed up!" Dr. Foreman pointing furiously at House, exclaimed, "you're not gonna let him die because you screwed up," the angry doctor continued.
"Technically, your case, so you screwed up," Quietly with a small, evil smile, House said, pointing back at Foreman. "Is that what this is about, looking bad in front of your old boss?" House asked, squinting at Dr. Foreman.
"You assaulted that man," Dr. Foreman replied, shaking his head at House's words.
"Fine," House declared, raising his hands in surrender. "I'll never do it again," putting one hand on his chest and the other in the air, House promised with false seriousness.
Yes, he will.
"Yes, you will," Dr. Foreman reproached, frustrated, as he walked out of the diagnostic lounge.
"Then all the more reason this debate is pointless," House said sarcastically, shrugging, before Dr. Foreman could fully leave the room.
Once Dr. Foreman stormed out of the room, an uncomfortable silence took over.
"Before we discuss why his lungs are worse," House said slowly, unaffected by Dr. Foreman's exit, "does anyone want to explain who she is?" House asked rhetorically, looking directly at me while pointing to the corner of the room.
Both Cameron and Chase, who hadn't noticed there was someone in the room, turned around, surprised to find Diane sitting with her back perfectly straight in the chair.
"I'm sorry, I didn't mean to be a distraction," Diane, who had been silent throughout the doctors' discussion, said apologetically, standing up from the small armchair she occupied with the formality that appeared when facing new people.
"Oh, don't worry," House declared with false kindness, waving his hand dismissively. "I love when people can see doctors having a mental breakdown; it always gives a feeling of relief and confidence in the guild," he added ironically.
"Yeah… Diane, these are Doctors Chase, Cameron, and House," I said, smiling apologetically at my friend and pointing to each doctor.
"Oh, so this is Diane?" Cameron asked, smiling significantly at me. "I've heard so much about you," she said, approaching Diane with a smile.
"Oh, really?" Diane asked, frankly surprised. "Perhaps you have read some of my papers," she added, still maintaining a strange formality.
"What?" Cameron murmured, taken aback.
"Yes, last year I published an article on a Functional Decomposition Method for the Efficient Resolution of Nonlinear Differential Equations," Diane said proudly, completely unaware of the reason for Cameron's question.
"I meant PJ, PJ has talked a lot about you," Cameron explained, smiling slightly as she reached Diane.
"Oh, yeah, that makes more sense," Diane murmured, lowering her head in embarrassment, loud enough for everyone to hear.
"From a cheerleader to someone with savant syndrome, and they say I'm a radical," House declared, smiling broadly and joking, causing Chase to snort and playfully elbow me.
"Cheerleader?" Diane asked, puzzled by House's mockery. They had called her a savant, but was that what mattered to her?
"Nothing," I quickly said, feeling the need to avoid talking about Regina. "Diane has a master's degree in mathematics from MIT," I added, changing the subject, causing Chase and Cameron to look at the girl in surprise. House, on the other hand, raised an eyebrow at me, obviously noticing my strange reluctance to talk about Regina.
"What's the factorial of fifteen?" House asked, slowly shifting his fixed gaze from me to Diane, interrupting any question Cameron might have asked Diane.
"What, House—" I said, incredulous at the man's behavior. Diane was very intelligent, but she wasn't a calculator.
"Eighty-seven billion, one hundred seventy-eight million, two hundred ninety-one thousand, two hundred," Diane calmly responded after a couple of seconds, interrupting my words and thought process without skipping a beat.
"The square root of that?" House asked, raising an eyebrow.
"Two hundred ninety-five thousand, two hundred fifty-nine point seven zero twelve, and change," Diane responded again, probably after a couple of seconds, visibly surprising Chase, Cameron, and me even more.
"Divided by seven," House said seriously, crossing his arms and now strangely ordering.
"Forty-two thousand, one hundred seventy-nine point ninety-five, and change," Diane responded completely calmly, with a trace of a tiny smile on her face.
I knew Diane was a genius, but it had never occurred to me to ask her for calculations in that way and that she could do it so easily.
"Okay, that's enough," I said, overcoming my surprise and looking angrily at House.
"Fine, I don't have a way to verify if what she said is correct anyway," House responded, shrugging disinterestedly.
"Oh, you can. I remember each of the operations; I can repeat them while you enter them into a calculator," Diane said, making her tiny smile a bit more visible, with a hint of smugness directed at House. Maybe I shouldn't have said everything I had about the man.
"That's really impressive," Cameron declared excitedly, smiling at Diane. "Can you do that?" she asked me a moment later. "I mean, you're also some kind of genius, right?"
"No, I can't," I quickly responded, feeling somewhat attacked.
"Yeah, PJ only knows a lot about medicine," Diane said, looking directly at me with a now visible, surprisingly slightly malicious smile. "In a trivia contest, he wouldn't be much help."
Surprised by Diane's sudden joking attitude, I could only smile with some pride at her more relaxed behavior.
"That's really cute," House declared, smiling falsely. "Now, the dying person?" he asked seriously a moment later, losing his smile. "His lungs are worse, any theories?" he asked again, bringing the conversation back to the case.
Both Cameron and I smiled apologetically at Diane, giving our attention to the chief doctor in the room.
"Vasculitis?" Chase asked, not entirely sure.
"I like it," I said, nodding. "The patient's MRIs are old and have a bit of static; they certainly didn't show anything, but there could always be errors or developments. IVIG in many cases could exacerbate vasculitis, inducing a much worse inflammatory response," I quickly added.
"Dr. House?" Before anyone else could say anything, a rather attractive woman carrying an envelope asked from the entrance of the lounge, entering the room.
She wore high heels that accentuated her legs, a visibly tight skirt a little above mid-thigh, and a shirt under an equally tight jacket, with far more buttons open than she should have had. It was obvious she intended to attract attention.
"Cuddy sent me a stripper again?" House asked fake excitedly as the woman walked toward him. "Love that woman, so thoughtful," he declared, placing a hand over his chest, feigning emotion.
"Sorry," the woman said without introducing herself, handing the envelope to House and walking out of the room.
House, completely unabashed, watched the woman's backside as she walked away from the lounge and calmly handed the envelope to Cameron.
"Wouldn't likely hit both lungs," House said, tilting his head, probably trying to catch the last glimpse of the woman. "You should know that," he added, raising an eyebrow at me once the woman was out of sight.
"I know that, but unlikely cases are what you usually work with, right?" I quickly responded, causing House to tilt his head slightly. "I feel we should at least update the last MRI; the newest one we have is over six months old," I said, raising my hands slightly.
"It could be Wegener's granulomatosis," Cameron said as she opened the envelope.
"There are case reports of Wegener's hitting both the lungs and the spine," I said, nodding, remembering reading those cases in the hospital library.
"It's not great, but it's better than ALS," House said slowly. "At least it's treatable."
"It's a restraining order," Cameron declared worriedly after reading the letter inside the envelope. "You're not to come within 50 feet of John Henry Giles, and they've asked the D.A. to file criminal charges for battery."
"Cameron, test the blood for C-ANCA," House ordered, completely unperturbed by the news.
"These are criminal charges; they're not going to let you take blood to make more tests," Cameron said seriously, showing the letter in her hand.
"He has blood left in the lab, just add on the C-ANCA," House said, shrugging, still not giving importance to the complicated situation. "Foreman still got you doing bronchoscopic suctioning for the pneumonia?" he asked Chase calmly.
"Every four hours," Chase responded quickly.
"Well, while you're down in his lungs, grab a biopsy," House ordered maliciously. "We'll need it to confirm Wegener's." Walking toward his office, he stopped abruptly. "Also, try to get an MRI for the kid," House ordered, pointing at me.
"Do you really think it's necessary?" Chase asked me seriously, not doubting my knowledge but rather a genuine question between colleagues.
"Yeah," I responded seriously, thinking about the strangeness of the reaction to IVIG.
"You just have to hide from Foreman; after all, the patient can't refuse," House declared sarcastically. "And speaking of that, one more thing: move the patient to the second-floor ICU," House said, stopping under the doorframe of his office.
"Why?" Cameron asked, puzzled.
"It's above the clinic," I responded, snorting and shaking my head, causing House to smile and nod.
"I'm pretty sure it's fifty feet in any direction," House said, smiling maliciously.
Of course, he would use a court order to his advantage somehow.
After receiving their orders, the other doctors left the lounge to complete their tasks, not without first smiling at Diane, who simply nodded awkwardly, bidding the doctors farewell.
Silently asking Diane to wait for me outside House's private office, I walked behind the doctor into his office.
"So, aren't you supposed to meet with the hospital lawyer?" I asked, following House into his office.
"How much do you know about these kinds of things, summons and trials?" House asked, sitting calmly in his chair.
"Not much, but I know the thyroid levels aren't going to work as a reason to ignore the DNR," I said seriously, taking a seat in front of House.
"Well, that's reason enough to find out what's wrong with him," House said, reclining in his chair, completely relaxed. "Now let's talk about you. How does it feel to chase someone who makes your intelligence look like that of a two-year-old?" House asked sarcastically, joining his hands in front of his face.
"We're just friends," I said exasperatedly, rolling my eyes. "And 'chase'? As if you know what that is," I retorted sarcastically, nodding at his cane.
"Oh yeah, make fun of the crippled," House said, snorting and shaking his head, feigning offense.
A moment after House spoke, his pager went off. "How long do you think a moderately decent team of doctors can move a comatose patient to the second-floor ICU?" House asked, squinting after checking his pager.
"Five minutes?" I replied, shrugging, not entirely sure.
"Let's round it to ten," House said, nodding slowly and checking his watch. "I suddenly have to go to the bathroom," he added, standing up slowly and smiling.
"Good luck," I murmured ironically, raising my eyebrows and walking behind House out of his office.
"It was a pleasure meeting you, Ramanujan," House said, smiling sarcastically at Diane before leaving the diagnostic lounge.
"I'm a woman, American, and obviously didn't die on April 26, 1920," Diane quickly said, frowning and stopping House. "From what PJ said, I thought you had some special deductive ability and a great memory. PJ said my name several minutes ago."
"Aw, you think I have a 'special deductive ability'?" House asked me, placing a hand over his chest, feigning tenderness, completely ignoring Diane's response.
"I think many things about you, House. Your work as a diagnostician is possibly the only good thing," I said, smiling seriously.
"Oh, the sting," House exclaimed with exaggerated pain on his face. "Look what you did, Ramanujan. When I mocked the cheerleader, he wasn't this defensive," House added, raising his eyebrows suggestively and continuing his way out of the room.
"I'm not Ramanujan, like I said. He was Indian and died in 1920," Diane said, slightly exasperated, raising her voice as House disappeared down the hallway, completely ignoring her.
Seeing me incredulously, Diane raised one of her hands slightly, silently asking what House's problem was.
"Diane, do you remember what I told you about House?" I asked, unable to avoid smiling slightly.
"Oh yeah," Diane murmured, raising her head a little embarrassed, probably for forgetting what I had said. "So this is 'any reason to mock anyone'?" she asked, nodding slowly.
"That was it," I murmured, nodding slowly.
"I get it… I think," Diane murmured, squinting, possibly absorbing the information.
"That's why I said, don't listen to anything he says," I reminded her, pressing my lips together. "Now, would you like to see where many of the medical techniques are practiced in the hospital?" I asked, clapping and changing the subject.
"Yes," Diane responded, interested, nodding. "Can I ask one more question?" she asked, walking beside me out of the diagnostic lounge.
"Of course, as many as you want," I replied, puzzled.
"Who is 'the cheerleader'?" Diane asked, obviously forcing a neutral expression while glancing at me sideways.
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Author Thoughts:
As always, I'm not American, not a doctor, not a fighter and I'm not Magnus Carlsen.
Another chapter has passed, so new thanks are in order. I would like to especially thank:
RandomPasserby96
11332223
Victor_Venegas
With that said,
I think that's all. As always, if you find any errors, please let me know, and I'll correct them immediately.
Thank you for reading! :D
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