Natalie
Title: Natalie
Prompt: #13. House/Wilson established: Being an oncologist has finally taken its toll on Wilson after a particularly hard passing of a patient, and he breaks down in the middle of the clinic while diagnosing a patient with a really petty problem.
Author: rslworks
Word Count: 3346
Disclaimer: Not mine.
Tag: breakdown
“Lost another peds patient yesterday, didn’t you?”
“Yeah.”
“You okay?”
“Will be.”
“Okay.”
House watched as Wilson picked up his briefcase and left the apartment, not looking back. He could always recognize when Wilson lost a patient, but over the years he’d become attuned to the difference when it was a pediatric patient.
It was glaringly evident to everyone who worked with him, that Wilson was accustomed to losing patients. Clearly, a doctor didn’t consider specializing in oncology without knowing what he or she could expect. Furthermore, one could not progress to the position of department head without having some success in dealing with dying and death on a daily basis. Wilson actively shared his experience and the tools needed to do this particular job with all the uninitiated staff members he influenced. If pressed, House himself might admit to being genuinely amazed that a person as sensitive and caring as James Wilson had developed the necessary skills that made him able to separate and compartmentalize the daily life and death struggles of others in order to focus on making a real contribution.
House regularly took jabs at Wilson over ‘job failure’ and mortality statistics simply because nothing much was sacred to him and he was competitive by nature. But the real truth was that House was always grateful that Wilson was able to get up and face another day after being knocked to the mat by another patient death. Ever since Wilson moved back in, House took some pride in being Wilson’s support system and confidant, though he would never admit openly to that degree of caring. But truth be told he also knew that Wilson had great inner strength and resolve of his own.
But the death of a pediatric patient House had learned not to be cavalier about. It was common for House to feel entirely helpless and shut out when Wilson came home to him on those occasions. He learned there was being ‘inconsolable’ and then there was the absolute refusal to be consoled which he experienced with Wilson.
It was the first decent spring day in Princeton, and since Wilson had already left, House decided to enjoy a death-defying motorcycle ride to work. He gave Wilson his space when he got there, and put his energies into the morning differential on a new patient.
After haranguing Kutner over what he considered a ridiculously lame history taking and watching him shuffle out of the room scowling, he proceeded to get rid of Taub by requesting a lumbar puncture on the patient. This left Foreman and Thirteen, who were only too happy for an excuse to leave the hospital grounds together, assigned to once again snoop around their poor patient’s house, hopefully gleaning something worthwhile to make up for the Swiss cheese history.
‘I must be going soft,’ House thought as he watched the lovebirds hurry just a little too much out of the diagnostics room, smiling furtively at each other, their thoughts private and transparent at the same time. ‘I’ll have to do something rude and insensitive to them later today to make up for this.’
With so much accomplished already, House felt a coffee break was in order and promptly headed down the hall to see if Wilson would join him. When he flung open the oncologist’s door, Wilson was on the phone, and House deduced from the degree of head shaking going on that his bestest bud was not enjoying the conversation.
“Great!” he exclaimed as he jammed the hand piece into its cradle.
“Is something the matter, oh unflappable one?” House sang out as he closed the door and hobbled to the couch.
Ignoring the unflappable crack, Wilson didn’t hesitate to begin complaining.
“Cuddy’s given me three extra shifts of clinic duty over the next ten days, and the first one is this afternoon!” He checked his watch, only to find it was 11:00 already.
House squinted as if in thought before replying. “-kay, none of us enjoy clinic, but you generally hate it the least. So, what’s up, dude?”
“What’s up is that she didn’t tell me until just now!” House noted with a straight face how cute it was that Wilson felt it necessary to point at the phone for emphasis.
“I’m swamped, House! Back to back appointments and procedures all week! I’m not like you, mulling over your one patient a week and just pushing what doesn’t suit you of the way! This department is becoming insane and I should be doing less clinic duty, not more!” He twisted the skin on the back of his neck until it had to hurt and grabbed the phone again.
“Catherine? Come up here as soon as you can please. I need to move some things around this afternoon. Thanks.”
“So I guess this means you don’t want to get a coffee just now?”
As soon as it was out of his mouth, House grabbed his cane and headed for the door, knowing an icy stare was all the answer he could expect.
House didn’t mind Wilson’s little tirades, because they almost never lasted. He was his direct opposite in this of course. House never lost a second of sleep over something he said to anyone. But given enough time, Wilson would come quietly back, having analyzed and examined every emotion and motive he had in him, and realize he’d probably overreacted. Wilson would adjust, make arrangements and just do the damn clinic duty without further complaint. He always did. He was James Wilson, Mr. Dependable.
At 2:00 pm sharp Wilson signed himself in for clinic duty.
Patient No. 1. - Female, mid 20s, Caucasian, presented with irregular periods and excessive pain and cramping. Palpation produced tenderness in region of right ovary. Sent patient for initial CBC and Chem panel, survey abdominal rads and instructions to return in 3 days for results. Tentative diagnosis - ovarian cyst?
Patient No. 2 - Forty-something, Caucasian male, cyclist - trauma to left knee after coming off his bike. Patient non-weight bearing. Knee appears hot, swollen with an audible click on extension. Sent for radiographs. Scripted analgesics. TDx - meniscal tear?
Patient No. 3 - Female, mid 70’s, Caucasian presented with shortness of breath, intermittent chest pain over 24 hrs. Administered oral ASA 325 mg and arranged immediate transfer to ER for further assessment. TDx - probable MI.
Patient No. 4 - Male, African American, late 50’s - complaining of persistent, non-productive cough 10 days post influenza. Auscultation of chest revealed mild wheezing and crackling, left side. Scripted broad spectrum Abs. DDx - bronchitis, secondary pneumonia?
Patient No. 5 - Male, 3 yr old Caucasian toddler - presented with acute injury to left forearm after fall in schoolyard. Bruising, swelling, obvious closed fracture to radius, +/- ulna. Physical exam for further injuries impossible due to extreme wailing of child and distraught mother. Sent for radiographs. Extra strength Ibuprofen for Dr. Wilson.
Wilson coughed harshly into his hand as his pill threatened to get stuck in his throat. Nurse Brenda paused in handing him the next patient file and he took the opportunity to take an extra sip of bottled water.
“Okay?” she said in her most bored voice.
“Peachy,” he sighed, opening the next file folder. “What the ---“ he began.
“Before you complain, she wouldn’t leave. It’s not my fault.” Brenda asserted.
This produced his most exasperated eye roll and he stalked off to Exam room 3.
“Missy Levine?” he said quietly as he opened the door. “I’m Dr. Wilson. What can I do for you today?”
Before him on the treatment table sat a pale, thin teenage girl wearing a vacant expression, designer jeans and tank top, and much too much makeup. She glanced at Dr. Wilson and then sat a little straighter and shook her hair out of her eyes, deciding she liked what she saw. In absolutely no mood for that, Wilson completely ignored the flirtation and waited for her to speak.
“Something’s wrong with my toes.”
“What, exactly?”
“They’re gross. Ugly.”
“Show me.”
She sat back on the table with her legs straight in front of her and kicked off her shoes.
Wilson dutifully stepped forward and had a look.
“I don’t see a problem, Miss,” he sighed.
“What do you mean? Look at my toenails! They’re all yellow!!”
He closed his eyes. The pain behind them intensified to a dull roar.
“Do you wear toe nail polish often, Miss Levine?”
“Are you kidding? All the time!” She cocked her head in a valley girl sort of way that made her perfectly straightened blonde hair shimmer in the harsh fluorescent lighting.
Wilson was now doing a slow burn, yet his ever present, polite restraint was engaged and he soldiered on. “There’s nothing to worry about here. The discolouration is very superficial which differentiates it from any kind of fungal infection. Your nails are in tact and your feet are perfectly healthy looking. You simply need to stop using nail varnish for a while and it will grow out.”
He paused a fraction of a second as she looked stricken. “Or paint over them again so you don’t have to look at it. I don’t much care, either way.”
Positive he had taken all he could stand, Wilson turned on his heel to leave the room. But before he yanked open the door he heard one thin, whiny exclamation.
“That’s it??”
Wilson’s vision blurred briefly and he rested his damp forehead against the back of the exam room door. Thud, thud…Then he turned.
“Excuse me?” His voice sounded edgy and distant in his own ears, as though belonging to someone else.
Before the girl could say anything more, he threw the thin file in the air with a flourish, oblivious as to where it landed. Missy watched with her mouth wide open as the doctor in front of her began to smile, then stumble forward laughing hysterically.
“I --“ she began.
He cut her off instantly, hands on hips. “Did you have something else to add, seriously?” His voice was harsh and sarcastic but there was an incredulous smile on his face at the same time. She watched as he turned aside and put a hand to his forehead, issuing another high pitched, desperate sort of breathy laugh that was even more frightening. Then he rounded on her again with a bellowing shout.
“Was there any other POSSIBLE WAY you could think of to waste my time? I don’t have much to do around here, really. Maybe you’d like to get some coffee and talk about boys or spring fashions!!”
Wilson ran a hand through his hair and began to pace in front of the teenager, now stunned into silence. It seemed as though he was going to say more, but a series of harsh gasps that still might be interpreted as laughter seemed to come out of him instead. His agitation seemed to spread rapidly from his feet through his entire body and as it built the girl drew her legs up and wrapped her arms around herself, hoping it would be over soon.
“What’s the matter?” he shouted again, watching her jump then bury her head in her arms. Wilson grabbed the edges of the treatment table and got close enough to see the girl tremble. “Rethinking your decision to come to the clinic today, are you? Well don’t be silly! I just love taking a well-deserved break to listen to pampered, self-absorbed, WITLESS teenage girls tell me all about their problems!”
He slapped the sides of his lab coat, then gesticulated wildly in the air again. “It’s such a nice change from most of my regular patients who spend their days here suffering and dying all around me!” His lips were a fraction of an inch from her left ear and he roared the words with everything he had in him.
A shrill series of screams drew the attention of the clinic nurses and Cuddy herself who had stopped at reception. The third exam room door burst open and a barefoot, frightened girl bolted toward the front entrance, crying and still shrieking. With the practiced calm that comes from long experience, Lisa Cuddy walked deliberately toward the exam room, fully expecting Greg House to appear in the doorway, shrug his shoulders and pop a Vicodin smugly in front of her.
Her face fell however, as she peered in to find James Wilson taking long strides around the small room, sweeping supplies off all the counters and sending them crashing to the floor. He whirled around and halted as he looked up at Cuddy.
“WHAT!!!”
She blinked several times, taken aback. Wilson was sweaty and dishevelled. His chest rose and fell rapidly and his pupils were dilated, making his eyes appear dark and threatening. Nurse Previn crept up tentatively behind her boss and looked over her shoulder into the room. Cuddy turned fractionally toward her and whispered, “House!” Previn disappeared.
“James,” Lisa began quietly. “What happened?” Her heart pounded in her chest as she waited for a response and for House.
House was having a fun day. Currently he had Kutner squirming while he seamlessly put together a flawless history from the tidbits Foreman and Thirteen had brought back to him. Taub was clearly enjoying the fact that he was in the safe zone for the time being when he thought he heard somebody’s pager. He checked.
“Not me,” he said.
House was clearly disappointed to be interrupted while at his ridiculing best, but he plucked his pager from his belt. “Wilson -meltdown- clinic -stat!”
Seeing House’s frivolity instantly evaporate, the team asked in unison, “What’s wrong?”
“Needed in the clinic. Forge ahead without me.” He grabbed his cane and fled for the elevators. His tone didn’t invite speculation, but the team merely looked at one another for a few moments and then wordlessly got to their feet to follow.
A small crowd had gathered outside the exam room by the time House arrived.
“This can’t be good,” he sing-songed under his breath.
He used his cane to part the gawkers none too gently and found Cuddy just inside the door. She turned to him flooded with relief.
“Thank God. He’s stopped shouting House, but he won’t talk to me. He verbally abused a teenaged patient with a petty complaint and then proceeded to trash the room. I’ve never seen him so agitated.”
“Get out.”
“House?”
“You heard me. Get out so I can close the door. And get all these people away from here.” She traded places with House and did just that.
Wilson didn’t acknowledge his presence, but House knew he was aware of him. He was facing the sink at the far wall of the room, rocking back and forth on his heels, fists deep in his lab coat. House quietly drew closer, hopping up on the exam table a few feet behind Wilson. He twirled his cane between his hands for a few seconds.
“What was her name?”
“How do you know it was a girl?”
“Didn’t. Fifty percent chance of getting it wrong. Gotta start somewhere.”
Wilson took a deep lungful of air and let it out through his nose slowly.
“Natalie. Her name was Natalie.” He whispered.
He turned around to face House and there were tear tracks lining his smooth face. He folded his arms, hugging himself, looking at the floor.
“I just couldn’t take any more crap, House,” he admitted, voice breaking.
“You want a sedative?”
“I don’t know. Maybe. I’m in trouble, aren’t I?”
“Mmm, maybe. I think Cuddy’s out there with a butt load of Ativan for you, but if you can calm down we might get through this. “
“We?” Wilson’s voice cracked once more.
“Of course, we, dummy.”
House used the hook of his cane to drag a stool to Wilson so he could sit. He sank down and loosened his tie. When he spoke, it was so quietly that House had to strain to hear.
“I met Natalie 7 years ago when she was only a four year old. She’d just moved here with her mother after a divorce and she got sick soon after. I diagnosed acute myeloid leukemia. Her induction chemotherapy was really lengthy and terribly, terribly tough on her, I remember, but she was a plucky thing, and when she achieved remission she did well for quite a long time. I actually had high hopes she might beat it.”
His head dropped and he looked away, trying to contain himself. “I only saw her for annual check ups for 3 straight years and she stayed strong and free of infections. But then one day she caught a viral infection and it hit her very hard. We had to discontinue immunosuppressive therapies for a while to give her a chance to gain some strength. But after all those years, any improvement was self-limiting. She got over the infection and then her remission ended. I’ve spent almost four years trying to stay ahead of her disease.” He stopped to rub the back of his neck.
“I know you don’t want to hear this, but she was an amazing little girl. She never appeared to feel sorry for herself. She was always more concerned about protecting her mother. I think she started to confide in me more and more as things got bad because there were a lot of things she was afraid to say to her. She was so worried near the end that her mother was going to be alone in the world.”
“But you’ve met kids like her before, right? You’re always hitting me over the head with their bravery and positive attributes, remember?” House reasoned.
“Yeah, House, I know. I’m just saying there was something really special about Nat. I don’t know, maybe because she didn’t have a Dad and I never had kids, I kinda felt -- I guess I wondered for a while how it would be to have her as my daughter. “
House raised his eyebrows. “So this isn’t a case of the Wilson guilt, this is ‘Oops! I got myself attached,’ Wilson.”
“I know. I broke the cardinal rule. No one comes to work for me without hearing that speech.” He scrubbed his hands over his face and looked at House for the first time.
“And then this patient today! I just couldn’t handle the incongruity of it all. It’s too much anymore. It’s just so unfair.” His voice hitched abruptly as bitterness choked him.
“I believe it’s called irony. And this is where those with a belief system of some sort get to say, you’re not God.”
“Nope. Don’t want the job,” he sighed.
House reached out an arm and hauled Wilson off the low stool to sit beside him on the table.
“So the question remains, Jimmy. What do you want to do now?”
He groaned and held his head with both hands. “You mean am I done with oncology? Or has Cuddy looked after that decision for me already?”
House smiled and rubbed his back. “I think you’re her star oncologist and star oncologist’s almost always get a second chance. But I do think you need a vacation.”
When that got no response, House turned to look and saw Wilson had closed his eyes, so he gently nudged him.
“Will you think about it? A vacation? Somewhere warm? Maybe with some suitable company?”
Wilson never opened his eyes. “House, I think I’m exhausted. I can’t even move right now.”
“I’ll take that as a yes.”
With that, he hopped off the table and had Wilson stretch out. “I’m gonna get you that sedative,” he began, “then Uncle Greg’s going to go put out some fires.”
“House?”
“Yeah?”
“I love you.”
“Don’t mention it. I mean, seriously, don’t mention it.”
Prompt: #13. House/Wilson established: Being an oncologist has finally taken its toll on Wilson after a particularly hard passing of a patient, and he breaks down in the middle of the clinic while diagnosing a patient with a really petty problem.
Author: rslworks
Word Count: 3346
Disclaimer: Not mine.
Tag: breakdown
“Lost another peds patient yesterday, didn’t you?”
“Yeah.”
“You okay?”
“Will be.”
“Okay.”
House watched as Wilson picked up his briefcase and left the apartment, not looking back. He could always recognize when Wilson lost a patient, but over the years he’d become attuned to the difference when it was a pediatric patient.
It was glaringly evident to everyone who worked with him, that Wilson was accustomed to losing patients. Clearly, a doctor didn’t consider specializing in oncology without knowing what he or she could expect. Furthermore, one could not progress to the position of department head without having some success in dealing with dying and death on a daily basis. Wilson actively shared his experience and the tools needed to do this particular job with all the uninitiated staff members he influenced. If pressed, House himself might admit to being genuinely amazed that a person as sensitive and caring as James Wilson had developed the necessary skills that made him able to separate and compartmentalize the daily life and death struggles of others in order to focus on making a real contribution.
House regularly took jabs at Wilson over ‘job failure’ and mortality statistics simply because nothing much was sacred to him and he was competitive by nature. But the real truth was that House was always grateful that Wilson was able to get up and face another day after being knocked to the mat by another patient death. Ever since Wilson moved back in, House took some pride in being Wilson’s support system and confidant, though he would never admit openly to that degree of caring. But truth be told he also knew that Wilson had great inner strength and resolve of his own.
But the death of a pediatric patient House had learned not to be cavalier about. It was common for House to feel entirely helpless and shut out when Wilson came home to him on those occasions. He learned there was being ‘inconsolable’ and then there was the absolute refusal to be consoled which he experienced with Wilson.
It was the first decent spring day in Princeton, and since Wilson had already left, House decided to enjoy a death-defying motorcycle ride to work. He gave Wilson his space when he got there, and put his energies into the morning differential on a new patient.
After haranguing Kutner over what he considered a ridiculously lame history taking and watching him shuffle out of the room scowling, he proceeded to get rid of Taub by requesting a lumbar puncture on the patient. This left Foreman and Thirteen, who were only too happy for an excuse to leave the hospital grounds together, assigned to once again snoop around their poor patient’s house, hopefully gleaning something worthwhile to make up for the Swiss cheese history.
‘I must be going soft,’ House thought as he watched the lovebirds hurry just a little too much out of the diagnostics room, smiling furtively at each other, their thoughts private and transparent at the same time. ‘I’ll have to do something rude and insensitive to them later today to make up for this.’
With so much accomplished already, House felt a coffee break was in order and promptly headed down the hall to see if Wilson would join him. When he flung open the oncologist’s door, Wilson was on the phone, and House deduced from the degree of head shaking going on that his bestest bud was not enjoying the conversation.
“Great!” he exclaimed as he jammed the hand piece into its cradle.
“Is something the matter, oh unflappable one?” House sang out as he closed the door and hobbled to the couch.
Ignoring the unflappable crack, Wilson didn’t hesitate to begin complaining.
“Cuddy’s given me three extra shifts of clinic duty over the next ten days, and the first one is this afternoon!” He checked his watch, only to find it was 11:00 already.
House squinted as if in thought before replying. “-kay, none of us enjoy clinic, but you generally hate it the least. So, what’s up, dude?”
“What’s up is that she didn’t tell me until just now!” House noted with a straight face how cute it was that Wilson felt it necessary to point at the phone for emphasis.
“I’m swamped, House! Back to back appointments and procedures all week! I’m not like you, mulling over your one patient a week and just pushing what doesn’t suit you of the way! This department is becoming insane and I should be doing less clinic duty, not more!” He twisted the skin on the back of his neck until it had to hurt and grabbed the phone again.
“Catherine? Come up here as soon as you can please. I need to move some things around this afternoon. Thanks.”
“So I guess this means you don’t want to get a coffee just now?”
As soon as it was out of his mouth, House grabbed his cane and headed for the door, knowing an icy stare was all the answer he could expect.
House didn’t mind Wilson’s little tirades, because they almost never lasted. He was his direct opposite in this of course. House never lost a second of sleep over something he said to anyone. But given enough time, Wilson would come quietly back, having analyzed and examined every emotion and motive he had in him, and realize he’d probably overreacted. Wilson would adjust, make arrangements and just do the damn clinic duty without further complaint. He always did. He was James Wilson, Mr. Dependable.
At 2:00 pm sharp Wilson signed himself in for clinic duty.
Patient No. 1. - Female, mid 20s, Caucasian, presented with irregular periods and excessive pain and cramping. Palpation produced tenderness in region of right ovary. Sent patient for initial CBC and Chem panel, survey abdominal rads and instructions to return in 3 days for results. Tentative diagnosis - ovarian cyst?
Patient No. 2 - Forty-something, Caucasian male, cyclist - trauma to left knee after coming off his bike. Patient non-weight bearing. Knee appears hot, swollen with an audible click on extension. Sent for radiographs. Scripted analgesics. TDx - meniscal tear?
Patient No. 3 - Female, mid 70’s, Caucasian presented with shortness of breath, intermittent chest pain over 24 hrs. Administered oral ASA 325 mg and arranged immediate transfer to ER for further assessment. TDx - probable MI.
Patient No. 4 - Male, African American, late 50’s - complaining of persistent, non-productive cough 10 days post influenza. Auscultation of chest revealed mild wheezing and crackling, left side. Scripted broad spectrum Abs. DDx - bronchitis, secondary pneumonia?
Patient No. 5 - Male, 3 yr old Caucasian toddler - presented with acute injury to left forearm after fall in schoolyard. Bruising, swelling, obvious closed fracture to radius, +/- ulna. Physical exam for further injuries impossible due to extreme wailing of child and distraught mother. Sent for radiographs. Extra strength Ibuprofen for Dr. Wilson.
Wilson coughed harshly into his hand as his pill threatened to get stuck in his throat. Nurse Brenda paused in handing him the next patient file and he took the opportunity to take an extra sip of bottled water.
“Okay?” she said in her most bored voice.
“Peachy,” he sighed, opening the next file folder. “What the ---“ he began.
“Before you complain, she wouldn’t leave. It’s not my fault.” Brenda asserted.
This produced his most exasperated eye roll and he stalked off to Exam room 3.
“Missy Levine?” he said quietly as he opened the door. “I’m Dr. Wilson. What can I do for you today?”
Before him on the treatment table sat a pale, thin teenage girl wearing a vacant expression, designer jeans and tank top, and much too much makeup. She glanced at Dr. Wilson and then sat a little straighter and shook her hair out of her eyes, deciding she liked what she saw. In absolutely no mood for that, Wilson completely ignored the flirtation and waited for her to speak.
“Something’s wrong with my toes.”
“What, exactly?”
“They’re gross. Ugly.”
“Show me.”
She sat back on the table with her legs straight in front of her and kicked off her shoes.
Wilson dutifully stepped forward and had a look.
“I don’t see a problem, Miss,” he sighed.
“What do you mean? Look at my toenails! They’re all yellow!!”
He closed his eyes. The pain behind them intensified to a dull roar.
“Do you wear toe nail polish often, Miss Levine?”
“Are you kidding? All the time!” She cocked her head in a valley girl sort of way that made her perfectly straightened blonde hair shimmer in the harsh fluorescent lighting.
Wilson was now doing a slow burn, yet his ever present, polite restraint was engaged and he soldiered on. “There’s nothing to worry about here. The discolouration is very superficial which differentiates it from any kind of fungal infection. Your nails are in tact and your feet are perfectly healthy looking. You simply need to stop using nail varnish for a while and it will grow out.”
He paused a fraction of a second as she looked stricken. “Or paint over them again so you don’t have to look at it. I don’t much care, either way.”
Positive he had taken all he could stand, Wilson turned on his heel to leave the room. But before he yanked open the door he heard one thin, whiny exclamation.
“That’s it??”
Wilson’s vision blurred briefly and he rested his damp forehead against the back of the exam room door. Thud, thud…Then he turned.
“Excuse me?” His voice sounded edgy and distant in his own ears, as though belonging to someone else.
Before the girl could say anything more, he threw the thin file in the air with a flourish, oblivious as to where it landed. Missy watched with her mouth wide open as the doctor in front of her began to smile, then stumble forward laughing hysterically.
“I --“ she began.
He cut her off instantly, hands on hips. “Did you have something else to add, seriously?” His voice was harsh and sarcastic but there was an incredulous smile on his face at the same time. She watched as he turned aside and put a hand to his forehead, issuing another high pitched, desperate sort of breathy laugh that was even more frightening. Then he rounded on her again with a bellowing shout.
“Was there any other POSSIBLE WAY you could think of to waste my time? I don’t have much to do around here, really. Maybe you’d like to get some coffee and talk about boys or spring fashions!!”
Wilson ran a hand through his hair and began to pace in front of the teenager, now stunned into silence. It seemed as though he was going to say more, but a series of harsh gasps that still might be interpreted as laughter seemed to come out of him instead. His agitation seemed to spread rapidly from his feet through his entire body and as it built the girl drew her legs up and wrapped her arms around herself, hoping it would be over soon.
“What’s the matter?” he shouted again, watching her jump then bury her head in her arms. Wilson grabbed the edges of the treatment table and got close enough to see the girl tremble. “Rethinking your decision to come to the clinic today, are you? Well don’t be silly! I just love taking a well-deserved break to listen to pampered, self-absorbed, WITLESS teenage girls tell me all about their problems!”
He slapped the sides of his lab coat, then gesticulated wildly in the air again. “It’s such a nice change from most of my regular patients who spend their days here suffering and dying all around me!” His lips were a fraction of an inch from her left ear and he roared the words with everything he had in him.
A shrill series of screams drew the attention of the clinic nurses and Cuddy herself who had stopped at reception. The third exam room door burst open and a barefoot, frightened girl bolted toward the front entrance, crying and still shrieking. With the practiced calm that comes from long experience, Lisa Cuddy walked deliberately toward the exam room, fully expecting Greg House to appear in the doorway, shrug his shoulders and pop a Vicodin smugly in front of her.
Her face fell however, as she peered in to find James Wilson taking long strides around the small room, sweeping supplies off all the counters and sending them crashing to the floor. He whirled around and halted as he looked up at Cuddy.
“WHAT!!!”
She blinked several times, taken aback. Wilson was sweaty and dishevelled. His chest rose and fell rapidly and his pupils were dilated, making his eyes appear dark and threatening. Nurse Previn crept up tentatively behind her boss and looked over her shoulder into the room. Cuddy turned fractionally toward her and whispered, “House!” Previn disappeared.
“James,” Lisa began quietly. “What happened?” Her heart pounded in her chest as she waited for a response and for House.
House was having a fun day. Currently he had Kutner squirming while he seamlessly put together a flawless history from the tidbits Foreman and Thirteen had brought back to him. Taub was clearly enjoying the fact that he was in the safe zone for the time being when he thought he heard somebody’s pager. He checked.
“Not me,” he said.
House was clearly disappointed to be interrupted while at his ridiculing best, but he plucked his pager from his belt. “Wilson -meltdown- clinic -stat!”
Seeing House’s frivolity instantly evaporate, the team asked in unison, “What’s wrong?”
“Needed in the clinic. Forge ahead without me.” He grabbed his cane and fled for the elevators. His tone didn’t invite speculation, but the team merely looked at one another for a few moments and then wordlessly got to their feet to follow.
A small crowd had gathered outside the exam room by the time House arrived.
“This can’t be good,” he sing-songed under his breath.
He used his cane to part the gawkers none too gently and found Cuddy just inside the door. She turned to him flooded with relief.
“Thank God. He’s stopped shouting House, but he won’t talk to me. He verbally abused a teenaged patient with a petty complaint and then proceeded to trash the room. I’ve never seen him so agitated.”
“Get out.”
“House?”
“You heard me. Get out so I can close the door. And get all these people away from here.” She traded places with House and did just that.
Wilson didn’t acknowledge his presence, but House knew he was aware of him. He was facing the sink at the far wall of the room, rocking back and forth on his heels, fists deep in his lab coat. House quietly drew closer, hopping up on the exam table a few feet behind Wilson. He twirled his cane between his hands for a few seconds.
“What was her name?”
“How do you know it was a girl?”
“Didn’t. Fifty percent chance of getting it wrong. Gotta start somewhere.”
Wilson took a deep lungful of air and let it out through his nose slowly.
“Natalie. Her name was Natalie.” He whispered.
He turned around to face House and there were tear tracks lining his smooth face. He folded his arms, hugging himself, looking at the floor.
“I just couldn’t take any more crap, House,” he admitted, voice breaking.
“You want a sedative?”
“I don’t know. Maybe. I’m in trouble, aren’t I?”
“Mmm, maybe. I think Cuddy’s out there with a butt load of Ativan for you, but if you can calm down we might get through this. “
“We?” Wilson’s voice cracked once more.
“Of course, we, dummy.”
House used the hook of his cane to drag a stool to Wilson so he could sit. He sank down and loosened his tie. When he spoke, it was so quietly that House had to strain to hear.
“I met Natalie 7 years ago when she was only a four year old. She’d just moved here with her mother after a divorce and she got sick soon after. I diagnosed acute myeloid leukemia. Her induction chemotherapy was really lengthy and terribly, terribly tough on her, I remember, but she was a plucky thing, and when she achieved remission she did well for quite a long time. I actually had high hopes she might beat it.”
His head dropped and he looked away, trying to contain himself. “I only saw her for annual check ups for 3 straight years and she stayed strong and free of infections. But then one day she caught a viral infection and it hit her very hard. We had to discontinue immunosuppressive therapies for a while to give her a chance to gain some strength. But after all those years, any improvement was self-limiting. She got over the infection and then her remission ended. I’ve spent almost four years trying to stay ahead of her disease.” He stopped to rub the back of his neck.
“I know you don’t want to hear this, but she was an amazing little girl. She never appeared to feel sorry for herself. She was always more concerned about protecting her mother. I think she started to confide in me more and more as things got bad because there were a lot of things she was afraid to say to her. She was so worried near the end that her mother was going to be alone in the world.”
“But you’ve met kids like her before, right? You’re always hitting me over the head with their bravery and positive attributes, remember?” House reasoned.
“Yeah, House, I know. I’m just saying there was something really special about Nat. I don’t know, maybe because she didn’t have a Dad and I never had kids, I kinda felt -- I guess I wondered for a while how it would be to have her as my daughter. “
House raised his eyebrows. “So this isn’t a case of the Wilson guilt, this is ‘Oops! I got myself attached,’ Wilson.”
“I know. I broke the cardinal rule. No one comes to work for me without hearing that speech.” He scrubbed his hands over his face and looked at House for the first time.
“And then this patient today! I just couldn’t handle the incongruity of it all. It’s too much anymore. It’s just so unfair.” His voice hitched abruptly as bitterness choked him.
“I believe it’s called irony. And this is where those with a belief system of some sort get to say, you’re not God.”
“Nope. Don’t want the job,” he sighed.
House reached out an arm and hauled Wilson off the low stool to sit beside him on the table.
“So the question remains, Jimmy. What do you want to do now?”
He groaned and held his head with both hands. “You mean am I done with oncology? Or has Cuddy looked after that decision for me already?”
House smiled and rubbed his back. “I think you’re her star oncologist and star oncologist’s almost always get a second chance. But I do think you need a vacation.”
When that got no response, House turned to look and saw Wilson had closed his eyes, so he gently nudged him.
“Will you think about it? A vacation? Somewhere warm? Maybe with some suitable company?”
Wilson never opened his eyes. “House, I think I’m exhausted. I can’t even move right now.”
“I’ll take that as a yes.”
With that, he hopped off the table and had Wilson stretch out. “I’m gonna get you that sedative,” he began, “then Uncle Greg’s going to go put out some fires.”
“House?”
“Yeah?”
“I love you.”
“Don’t mention it. I mean, seriously, don’t mention it.”