Wilson Interrupted
Title: Wilson interrupted.
Prompt: #106. Wilson suffers an abrupt personality change where he’s mean to everyone, and House tries to diagnose the cause.
Author: rslworks
Word Count: 4124
Disclaimer: not mine
Tags: mystery
Greg House had a niggling feeling buried somewhere deep in that complicated mind, perhaps related to something he might be forgetting. Much like a cat chasing a feather on a windy day, it tickled and teased him for a few moments, and then he dismissed it. He eased himself into his desk chair struggling to decide whether to fire up his game boy or hack into the Dean’s e-mail, when the aforementioned Dean of Medicine came through his office door, wearing a lovely mauve suit and a concerned frown. Cuddy never took long to get to her point, so House merely raised his eyebrows and gave her his full attention.
“What is going on with Wilson?” She sat in the chair opposite the desk with her hands in her lap and waited for the answer.
“Why? What’s he done?” House always felt it was clever to answer a question with a question.
Cuddy continued, “Have you talked to him today?”
“No. Can’t say that I have. He’s made himself a bit scarce lately now that I think about it. So what happened??” He said the last part slowly and loudly as if she were deaf. She rolled her eyes in response.
“Apparently, Dr. Wilson was getting ready to perform a routine lymph node biopsy this morning with an assist from one of his newest nurses. She knocked over the instrument tray and Wilson went completely ballistic on her, in front of the patient! She told me he was so angry and shaking so badly that he stormed out of the room with instructions for Roland to do the damn biopsy.” She waved her hand through the air once before continuing, “It’s just so unlike Wilson to be unprofessional. And it’s silly for something like that to get to him! I’ve questioned most of his nurses and assistants in the last hour and they all say he’s been abrupt and irritable for over a week. You didn’t notice?”
House peered into his hands for a moment, then piped up with, “Wow. Sounds like you should have a sit down with him.”
“House! I am going to talk to him, of course. I just thought you might be able to tell me if there’s something bothering him. I don’t pry into my department heads’ personal lives unless their performance warrants it, so if there’s something I should know about before I march in there and confront him, well,” she stopped and sighed heavily, “you’d tell me, wouldn’t you? For his sake?”
She stood up and began to pace in front of House’s desk. “I’ve never had a single complaint of a personal nature against Wilson, from patients or staff in the 11 years he’s run the Oncology department for me.” Looking directly at House, she continued, “If this is some sort of personal problem that’s going to run its course, then fine, we’ll get through it. But I also know how high the burn out rate is for oncologists and if my most reliable department head is in trouble, I need to know. You’re his friend. Talk to him, House. Watch out for him. He’s done it often enough for you.
And by the way, I’m pretty sure you have Clinic right now. Put the game boy away.”
And with that parting shot, she was out the door heading directly for Wilson’s office.
The dim bulb reserved for clinic duty lit up in his brain. “Yes, Mommy,” he called after her.
House found it necessary to shift priorities from spying on Cuddy to investigating what was up with Wilson. It caught him seriously off guard that he wasn’t the first to spot something amiss with him and he pledged to make up for that dereliction of duty starting now. Wilson could be admirably sneaky and devious when he didn’t want anyone (House) to know his business.
At noon, he gave Wilson ten minutes to see if he’d initiate an invitation to lunch, but when his stomach growled in complaint he went to get him. Flinging open the door as per usual, he was hit in the face with a blast of hot, stuffy air.
“Good Lord! Is your thermostat broken?! It’s an oven in here! How can you sit here in this? And in your lab coat! You aren’t even sweating! What’s wrong with you, anyway?”
“Nothing. I thought the heat might be a deterrent for you. Clearly, I was mistaken,” Wilson offered sarcastically. “Did you actually want something?”
House stepped closer, examining Wilson’s face. He was fairly certain the tired eyes, dull hair and pale, puffy face he observed now were not there last week.
“It’s lunch time,” House informed him pointedly. “Let’s get out of this heat. No wonder you’re cranky!”
Wilson lifted his hand from his mouse and crossed his arms in front of his chest, glowering at House. “I’m not cranky. I’m not hungry. I’m tired and I have too much to do. I want the heat where it is, thank you. If you don’t like it, get out.”
House felt he had no choice but to postpone his interrogation until Wilson was a little more agreeable. It didn’t, however, solve the problem of his growling stomach.
“I need ten dollars for lunch.”
“GET THE HELL OUT OF HERE!!!” Wilson screeched.
* * *
When Taub, Kutner and Thirteen regrouped in Diagnostics after lunch, the white board they planned to consult had been wiped clean and replaced with symptoms they didn’t recognize. Foreman came in last and his eyes fell on House, sitting at the head of their table, bouncing his red and grey ball, staring intently at the new board. No one spoke for a few moments.
Foreman eventually had to ask, “What’s going on, House?”
Bolstered by Foreman’s initiative, Kutner added, “Yeah! Our treatment plan isn’t working, but I don’t see any evidence of these symptoms? Am I missing something?”
House rubbed the bridge of his nose and winced. “Yes, oh obtuse one. You usually are…New patient, people!”
“But we haven’t fixed the old one.” Kutner insisted.
“Is the patient dying?”
“No. Not yet.”
“Then, new patient!!” He ignored the vacant expressions and read his new list out loud. “Irritability, temper tantrums, sensitivity to cold, fatigue.”
“Not a whole lot to go on,” Taub observed. “This wouldn’t be about Wilson, would it?”
When House gave no reply, he went on. “It’s already all over the hospital that Wilson wigged out this morning. Those oncology nurses are a gossipy bunch,” he smiled. He looked up to expressionless faces.
“Not that they don’t care about him. I’m sure that they do, really.” He stopped before he buried himself completely.
Thirteen came to the rescue. “Rage and irritability could have dozens of implications, most of them relating to mental illness; depression, specifically manic depression, schizophrenia, dementia, anxiety disorders. But there’s also complex partial seizure activity, steroid abuse, antidepressant/anxiolytic med withdrawal, metabolic and endocrine abnormalities.” She threw up her hands. “We need more information, and he needs a full work up if you’re going to take this seriously. House, maybe he’s just having a bad day.”
That evening Wilson picked up some Indian samosas on the way home only to watch them go cold on the coffee table before him. He sighed and retrieved a second beer from the fridge instead. ‘So much for comfort food,’ he thought.
He was still really angry with Cuddy for reprimanding him and wished she’d kept her nose out of his department. He wasn’t sure why things weren’t going well lately, but he was perfectly capable of sorting it out.
His muttering to himself was interrupted by the telephone and he listened apathetically as House left a message to the effect that he knew he was home and to get off his ass and call him back.
‘He doesn’t care,’ Wilson thought, snuggling deeper into the couch with a soft blanket around him. ‘Cuddy’s just got him checking up on me,’ he concluded resentfully as he shivered and soon fell asleep dreaming of Amber and happier times.
* * *
“I’m just trying to understand why you did this!” Wilson was standing behind his desk, hands on hips when they weren’t gesticulating wildly in the air. Blotchy, red marks had crept up his throat, to his ears and he was hopping mad.
Catherine, his long time assistant, stood on the other side of the desk, trying to keep her composure and reason with her boss to defuse a situation she didn’t understand. “I thought it was for the best! And I made certain we could easily reschedule that meeting when you’re feeling up to it. I mean, more so. I mean …you used to trust my judgment---”
“When I’m WHAT?” he spat back. “I have been waiting for the opportunity to see these people for over three months, and what are you implying, anyway? Since when do you have a different agenda from mine?” He ran his hand through his hair. “You knew this was important! You knew I wanted to set the tone---”
“Yes! I knew how sensitive it was!” she shouted back in her defence. “And I didn’t want you to screw it up!” She turned and fled the office, head down, ignoring the onlookers, including House, who had heard the raised voices even through the closed door.
House pushed on the now ajar door tentatively with his cane and immediately ducked as a bud vase whizzed over his head and smashed out in the hall.
“Maybe that should have been one of your teddy bears,” House began, looking out at the mess.
“What’s the matter with everybody?!” Wilson squeaked out in a hoarse whisper.
Ten minutes later, a confused and dejected James Wilson sat before Lisa Cuddy with his head in his hands. For her part, Cuddy leaned on the front of her desk with her ankles crossed and arms folded, looking at the top of his head and trying not to feel like she was kicking a puppy.
“Listen to me, Wilson,” she said quietly. “I want you to have some tests run.”
She paused to let him groan for a moment. “Listen! Something is going on. This isn’t you. And you can’t just go around yelling at hospital personnel indefinitely. Catherine has been here as long as any of us, for God’s sake. She’s very upset!”
“I’m sorry,” he offered, unable to look up. “I’ll apologize right away.”
“No,” Lisa said, standing up in front of him. “That can wait. Unless you can explain this, like telling me it’s delayed stress from Amber’s death and you need more personal time, I’m asking you to walk over to the Clinic with House and submit to a complete physical exam and work up. Today. Now.”
With that, she looked up and signalled to House whom she had been banished to the outer office while they talked. Wilson remained silent and still while Cuddy walked toward House.
“Work him up,” she said softly, taking his arm. “Get lots of blood. I want this to be extensive. Find something we can fix, House.” She looked back but Wilson didn’t appear to be paying them any attention. “And do a full thyroid panel, not just the TSH test. I think, ”
“Yes, Dr. Cuddy! The endocrinologist thinks endocrine. I get it! I just may have done this before.”
“I know, but this is Wilson.”
“I know that, too,” he concluded, eager to move on from her hand-wringing worry. “Come on, Jimmy boy. You’re mine to have my wicked way with!”
* * *
“Oww!! God, you’ve got the finesse of a lumberjack, you know that!” Wilson barked as House plunged the vacutainer needle into his vein. Blood instantly began to pour forth, but House looked coolly into Wilson’s eyes with his jaw clenched, and yanked the needle out, pitching the whole tube into the sink.
“That’s it! Someone else can get your blood! You are done yelling at me, you got that! And hold that off! You’re bleeding down your arm, idiot!”
Wilson belatedly pressed two fingers in the crook of his arm and sat forward in his seat, breathing heavily, desperate to maintain some composure. It wasn’t to be. House turned away to find a band aid and when he swivelled back, hot tears were streaming down his friend’s face. He hadn’t seen those since Amber.
“I’m sorry,” he sobbed, unable to look at House. “I’m so dead tired, I just feel overwhelmed…I don’t know what’s going on or where all this hostility is coming from!”
Instantly ill at ease, but mindful of all this friendship had suffered, House made the supreme effort to step up to the plate this time rather than turn tail and run.
“It’s okay,” he said simply. He reached out and uncurled Wilson’s arm very gently, applying the band aid. “Let’s take one thing at a time and let me do the tests. It’s only overwhelming when you don’t have any answers, right?” His warm hand remained firmly on Wilson’s left arm and that one small gesture did not go unnoticed.
Smiling weakly, James sniffed and nodded. “Thanks. I’m okay. Self-control’s in short supply these days.”
“Tell me something I don’t already know; like symptoms, all of them, in order of appearance. And hop up on the exam table, open your shirt and loosen your pants. The clock’s ticking here and you’re only getting crankier!”
With no more discussion House proceeded to examine him from head to foot.
When it was clear he was finished with the physical, Wilson wordlessly extended his other arm for blood collection. House smirked, but held his tongue and gathered fresh supplies before he could change his mind.
“My God, House, I think I’m gonna need some orange juice before I get up from here. You took 9 vials!! I don’t remember saying I was donating blood at the same time!” Wilson communicated this more as an observation than a bad tempered complaint this time.
“Oh, suck it up. You can buy me an early lunch and get your juice then.”
“So what are you thinking? Out with it.” Wilson prompted, fatigue creeping back into his husky voice.
“What? You want me to hazard a guess before the blood work comes back?”
Wilson rolled his eyes as he pushed down his sleeves and moved on to the buttons on his shirt. “House, your worst guess is usually closer than anyone else’s expertise. You have to be thinking something.”
“So do you. You’re a doctor.”
He sighed in response, pinching the bridge of his nose. “You’d be surprised, House, and no smart ass remarks, either! Now that I’ve been confronted with this thing I realize I can’t remember the last time I had any energy or got up without aches and pains. I’m already depressed and having trouble concentrating. There’s nothing earth shattering in that. Besides, I’m painfully aware I’ve just had my fortieth birthday. I thought I was just slowing down, House. You know, getting older.”
“Good God, man. Speak for yourself! And you’re forty, not eighty! Besides what you just said, here’s what I see. Then we’ll play name that disease process!”
His leg was seriously complaining, so he hoisted himself up on the table beside Wilson before going on. “Your skin and hair are dull and dry. Your face is even paler than it usually is and there’s a discreet puffiness that wasn’t there about a week ago. You’re ridiculously cold even in reasonable environments. Your voice, even though you’ve been choosing to strain it a lot lately, is hoarse and thin. Your pulse, interestingly enough was sitting at 42 bpm. I took it twice.”
Wilson looked at House, beginning to pay attention.
“Admittedly that’s a resting heart rate, but I’ll wager if I had you up doing jumping jacks, it wouldn’t get much higher. And I saved the best for last.”
Turning to face the patient, their knees knocking each other, House reached for Wilson’s throat with both hands. Recoiling slightly, Wilson looked dubious until House began to run his fingers down the front of his throat, branching out and down over his Adam’s apple. “Tell me you didn’t notice this, genius?”
Wilson pushed House’s hands away so he could palpate his own throat. He looked at House with widening eyes as he realized his own fingers didn’t lie.
“Oh, crap. House it hasn’t been this swollen very long. I would have noticed when I was shaving, I’m sure. And I’m not having trouble swallowing. Well,” and he swallowed pointedly, “maybe just a little today.”
House rolled his eyes so far back in his head he made himself dizzy. “Cuddy, the endocrinologist gets a point for this one. We’ll know for sure when the labs come back, but we can probably blame all your socially unacceptable symptoms on hypothyroidism. That means levothyroxine for life, I’m afraid. We can pop pills together.”
Wilson was shaking his head. “It’s hard to believe. I mean, I have absolutely no family history,---”
“It’s less common by two thirds in men, but it’s the men who seem to be more prone to hostility and episodes of rage; that and the decreased libido, premature ejaculation and outright impotence. But unless my radar is off, you haven’t been getting any since….well, never mind. My bad.” He hopped off the table before Wilson could take a swing at him, verbally or otherwise.
James went back up to his office to catch up on some harmless paperwork. His staff was sidestepping him left and right and he felt so guilty even armed with a possible medical excuse, that he just pocketed his hands and looked at the floor. Once he had his diagnosis he would apologize to Catherine in person: with flowers, in fact. Yeah, it was the least he could do, he judged. Maybe chocolate, too…
Next day, Wilson woke feeling tired, achy and cranky as expected, but determined to keep a tight rein on his temper. He was anxious to get to work and see what his labs revealed. Though House had followed a trail of symptoms and physical findings to their most logical conclusion, they had not delved into possible reasons for those findings. Admittedly, oncologists think about cancer and Wilson could not entirely push away the idea that there could be a tumour on his thyroid. It was sobering to experience for himself a tiny bit of what every last one of his patients must go through.
Feeling like the eighty year old man House was trying not to compare him to, he shuffled to the bathroom, hand on his aching hip and feeling his throat for the now obviously inflamed thyroid gland. Knowing from recent experience that a hot shower would work temporary wonders, he let the hot water pulse over his back, shifting his stance to allow the spray to beat down on his tender hip.
When he had towelled himself off, he hoisted his blow dryer and styled his hair with practiced skill. His last cut was far too short to allow him to work any magic with it however, so he was done rather quickly. Ten minutes later he was out the door, promising himself something from the diner on the corner for breakfast. House would snatch the labs as soon as they were available online, so Wilson tried to concentrate on other things when he got to his office.
After a total of seven different pages that were about something other than his test results, Wilson sighed with relief when the pager went off one more time and he looked down to read, ‘Labs in, Cuddy’s office now, H.’
He was momentarily dismayed that he was going to get his results after Cuddy did for some reason, but he got over it and nearly sprinted to the elevators. Knocking, but not waiting for permission, he walked in and looked directed at House, then Cuddy, and back again. House sat on her comfy couch dangling his cane from one finger, his expression difficult to read, but James realized it could simply mean his results were as expected, and therefore boring.
Cuddy smiled warmly from her desk chair. “Morning, Wilson. How are you feeling?”
“Okay; about the same, really. You’ll be glad to know I haven’t read anyone the riot act today.” He adopted one of his goofier smiles and she laughed.
“Terrific. I’m proud of you.” She picked up the single sheet of paper before her without delay. “I know you’re anxious for these, so I’ll get right to it.”
Wilson sank into the chair opposite Cuddy.
“As we suspected, your results do point to hypothyroidism. Your cholesterol is quite elevated, your white cell count is up, as is your TSH and other thyroid indicators like T3 and T4.”
“Okay,” he nodded in an overly animated way. “I can live with that. It’s simple to treat. Anything else?” He glanced at House for any more clues, but he was actively engaged in leering down Cuddy’s blouse from the sidelines.
“Yes. You must be wondering why these symptoms would abruptly appear at this statistically early stage in your life. You are a bit young, after all for a simple endocrine problem to come along.”
Something nauseating that Wilson quickly recognized as dread, began to well up from the pit of his stomach and he actively felt any remaining colour leach out of his face.
“James? You look awful. Are you okay?” Cuddy stood and came around to him.
“Oh good God, woman!” House exploded. “You’re babbling away to an oncologist here!”
“Oh, Wilson, no no! I’m so sorry! It’s not lymphoma. It’s not thyroid cancer. Think autoimmune instead.” Cuddy soothed, placing her hand on his shoulder.
“What?” Wilson trained his anxious eyes upon House.
House stood and brushed past Cuddy with a quick, “You’re fired!”
“Wilson, you have Hashimoto’s thyroiditis.”
“The original autoimmune disease?” Wilson asked.
House nodded curtly. “That’s the one. Just because you don’t know of any relatives who’ve had it, doesn’t mean they weren’t carriers. We can check your DNA to confirm, but you have the antibodies against thyroid peroxidase in your blood. Cuddy included that test. She may suck at doctor speak, but she’s not too bad of an endocrinologist.”
“Oh, you two get out, then! Deal with it yourselves!” She sat behind her desk again and addressed only James.
“Wilson, I’m glad it’s something treatable. Get started on Levothyroxine today. You should begin to feel a lot better in a few days, but retest your drug levels in 14 days. Anything else, ask the great and terrible House.”
“Thanks, Cuddy,” Wilson tried for sincerity but amusement coloured his voice, and he rose quickly with House at his side.
“Well,” Wilson began as they fell into stride together in the hall.
“Go on,” prompted House, popping a Vicodin.
“I just have to wonder when my immune system decided to tank,” he explained.
“Seriously? Let’s see, there’s your girlfriend’s demise, your brother’s reappearance and untreated schizophrenia, there’s your depressing job which perpetually feeds off that need to be needed psyche of yours, and most importantly, there’s ME; your biggest responsibility! And I can probably overwhelm anyone’s immune system all by myself. You think?”
Wilson stopped and turned. He looked into House’s clear blue eyes, and no snappy comeback line came forth. House had said it. It was his way of acknowledging the burden of friendship he singularly placed upon Wilson. Friendship with Gregory House was not easy. He made a lousy friend in the traditional sense. But Wilson had recently decided he didn’t have much use for traditional. Almost every exciting thing he’d ever done in his adult life had been shared with House. And now House was looking back at him sharing a rare moment of transparency he would always remember.
But Wilson’s quiet realization of a ‘moment’ between them was suddenly making House wickedly uncomfortable, so he took pity on him with practiced deflection.
“Cuddy does suck when it comes to giving test results though, doesn’t she?” he said conspiratorily as they resumed their walk.
House gave a short burst of laughter. “Big time!”
Wilson reached over for his arm. “For a minute there I thought I was gonna die, and I’m the one that knows thyroid cancer can be cured!”
At this, House dissolved completely into a rare fit of giggles, pushing Wilson away and folding himself over his cane. For Wilson’s part, he stood back and admired his accomplishment, supremely pleased with himself.
Prompt: #106. Wilson suffers an abrupt personality change where he’s mean to everyone, and House tries to diagnose the cause.
Author: rslworks
Word Count: 4124
Disclaimer: not mine
Tags: mystery
Greg House had a niggling feeling buried somewhere deep in that complicated mind, perhaps related to something he might be forgetting. Much like a cat chasing a feather on a windy day, it tickled and teased him for a few moments, and then he dismissed it. He eased himself into his desk chair struggling to decide whether to fire up his game boy or hack into the Dean’s e-mail, when the aforementioned Dean of Medicine came through his office door, wearing a lovely mauve suit and a concerned frown. Cuddy never took long to get to her point, so House merely raised his eyebrows and gave her his full attention.
“What is going on with Wilson?” She sat in the chair opposite the desk with her hands in her lap and waited for the answer.
“Why? What’s he done?” House always felt it was clever to answer a question with a question.
Cuddy continued, “Have you talked to him today?”
“No. Can’t say that I have. He’s made himself a bit scarce lately now that I think about it. So what happened??” He said the last part slowly and loudly as if she were deaf. She rolled her eyes in response.
“Apparently, Dr. Wilson was getting ready to perform a routine lymph node biopsy this morning with an assist from one of his newest nurses. She knocked over the instrument tray and Wilson went completely ballistic on her, in front of the patient! She told me he was so angry and shaking so badly that he stormed out of the room with instructions for Roland to do the damn biopsy.” She waved her hand through the air once before continuing, “It’s just so unlike Wilson to be unprofessional. And it’s silly for something like that to get to him! I’ve questioned most of his nurses and assistants in the last hour and they all say he’s been abrupt and irritable for over a week. You didn’t notice?”
House peered into his hands for a moment, then piped up with, “Wow. Sounds like you should have a sit down with him.”
“House! I am going to talk to him, of course. I just thought you might be able to tell me if there’s something bothering him. I don’t pry into my department heads’ personal lives unless their performance warrants it, so if there’s something I should know about before I march in there and confront him, well,” she stopped and sighed heavily, “you’d tell me, wouldn’t you? For his sake?”
She stood up and began to pace in front of House’s desk. “I’ve never had a single complaint of a personal nature against Wilson, from patients or staff in the 11 years he’s run the Oncology department for me.” Looking directly at House, she continued, “If this is some sort of personal problem that’s going to run its course, then fine, we’ll get through it. But I also know how high the burn out rate is for oncologists and if my most reliable department head is in trouble, I need to know. You’re his friend. Talk to him, House. Watch out for him. He’s done it often enough for you.
And by the way, I’m pretty sure you have Clinic right now. Put the game boy away.”
And with that parting shot, she was out the door heading directly for Wilson’s office.
The dim bulb reserved for clinic duty lit up in his brain. “Yes, Mommy,” he called after her.
House found it necessary to shift priorities from spying on Cuddy to investigating what was up with Wilson. It caught him seriously off guard that he wasn’t the first to spot something amiss with him and he pledged to make up for that dereliction of duty starting now. Wilson could be admirably sneaky and devious when he didn’t want anyone (House) to know his business.
At noon, he gave Wilson ten minutes to see if he’d initiate an invitation to lunch, but when his stomach growled in complaint he went to get him. Flinging open the door as per usual, he was hit in the face with a blast of hot, stuffy air.
“Good Lord! Is your thermostat broken?! It’s an oven in here! How can you sit here in this? And in your lab coat! You aren’t even sweating! What’s wrong with you, anyway?”
“Nothing. I thought the heat might be a deterrent for you. Clearly, I was mistaken,” Wilson offered sarcastically. “Did you actually want something?”
House stepped closer, examining Wilson’s face. He was fairly certain the tired eyes, dull hair and pale, puffy face he observed now were not there last week.
“It’s lunch time,” House informed him pointedly. “Let’s get out of this heat. No wonder you’re cranky!”
Wilson lifted his hand from his mouse and crossed his arms in front of his chest, glowering at House. “I’m not cranky. I’m not hungry. I’m tired and I have too much to do. I want the heat where it is, thank you. If you don’t like it, get out.”
House felt he had no choice but to postpone his interrogation until Wilson was a little more agreeable. It didn’t, however, solve the problem of his growling stomach.
“I need ten dollars for lunch.”
“GET THE HELL OUT OF HERE!!!” Wilson screeched.
* * *
When Taub, Kutner and Thirteen regrouped in Diagnostics after lunch, the white board they planned to consult had been wiped clean and replaced with symptoms they didn’t recognize. Foreman came in last and his eyes fell on House, sitting at the head of their table, bouncing his red and grey ball, staring intently at the new board. No one spoke for a few moments.
Foreman eventually had to ask, “What’s going on, House?”
Bolstered by Foreman’s initiative, Kutner added, “Yeah! Our treatment plan isn’t working, but I don’t see any evidence of these symptoms? Am I missing something?”
House rubbed the bridge of his nose and winced. “Yes, oh obtuse one. You usually are…New patient, people!”
“But we haven’t fixed the old one.” Kutner insisted.
“Is the patient dying?”
“No. Not yet.”
“Then, new patient!!” He ignored the vacant expressions and read his new list out loud. “Irritability, temper tantrums, sensitivity to cold, fatigue.”
“Not a whole lot to go on,” Taub observed. “This wouldn’t be about Wilson, would it?”
When House gave no reply, he went on. “It’s already all over the hospital that Wilson wigged out this morning. Those oncology nurses are a gossipy bunch,” he smiled. He looked up to expressionless faces.
“Not that they don’t care about him. I’m sure that they do, really.” He stopped before he buried himself completely.
Thirteen came to the rescue. “Rage and irritability could have dozens of implications, most of them relating to mental illness; depression, specifically manic depression, schizophrenia, dementia, anxiety disorders. But there’s also complex partial seizure activity, steroid abuse, antidepressant/anxiolytic med withdrawal, metabolic and endocrine abnormalities.” She threw up her hands. “We need more information, and he needs a full work up if you’re going to take this seriously. House, maybe he’s just having a bad day.”
That evening Wilson picked up some Indian samosas on the way home only to watch them go cold on the coffee table before him. He sighed and retrieved a second beer from the fridge instead. ‘So much for comfort food,’ he thought.
He was still really angry with Cuddy for reprimanding him and wished she’d kept her nose out of his department. He wasn’t sure why things weren’t going well lately, but he was perfectly capable of sorting it out.
His muttering to himself was interrupted by the telephone and he listened apathetically as House left a message to the effect that he knew he was home and to get off his ass and call him back.
‘He doesn’t care,’ Wilson thought, snuggling deeper into the couch with a soft blanket around him. ‘Cuddy’s just got him checking up on me,’ he concluded resentfully as he shivered and soon fell asleep dreaming of Amber and happier times.
* * *
“I’m just trying to understand why you did this!” Wilson was standing behind his desk, hands on hips when they weren’t gesticulating wildly in the air. Blotchy, red marks had crept up his throat, to his ears and he was hopping mad.
Catherine, his long time assistant, stood on the other side of the desk, trying to keep her composure and reason with her boss to defuse a situation she didn’t understand. “I thought it was for the best! And I made certain we could easily reschedule that meeting when you’re feeling up to it. I mean, more so. I mean …you used to trust my judgment---”
“When I’m WHAT?” he spat back. “I have been waiting for the opportunity to see these people for over three months, and what are you implying, anyway? Since when do you have a different agenda from mine?” He ran his hand through his hair. “You knew this was important! You knew I wanted to set the tone---”
“Yes! I knew how sensitive it was!” she shouted back in her defence. “And I didn’t want you to screw it up!” She turned and fled the office, head down, ignoring the onlookers, including House, who had heard the raised voices even through the closed door.
House pushed on the now ajar door tentatively with his cane and immediately ducked as a bud vase whizzed over his head and smashed out in the hall.
“Maybe that should have been one of your teddy bears,” House began, looking out at the mess.
“What’s the matter with everybody?!” Wilson squeaked out in a hoarse whisper.
Ten minutes later, a confused and dejected James Wilson sat before Lisa Cuddy with his head in his hands. For her part, Cuddy leaned on the front of her desk with her ankles crossed and arms folded, looking at the top of his head and trying not to feel like she was kicking a puppy.
“Listen to me, Wilson,” she said quietly. “I want you to have some tests run.”
She paused to let him groan for a moment. “Listen! Something is going on. This isn’t you. And you can’t just go around yelling at hospital personnel indefinitely. Catherine has been here as long as any of us, for God’s sake. She’s very upset!”
“I’m sorry,” he offered, unable to look up. “I’ll apologize right away.”
“No,” Lisa said, standing up in front of him. “That can wait. Unless you can explain this, like telling me it’s delayed stress from Amber’s death and you need more personal time, I’m asking you to walk over to the Clinic with House and submit to a complete physical exam and work up. Today. Now.”
With that, she looked up and signalled to House whom she had been banished to the outer office while they talked. Wilson remained silent and still while Cuddy walked toward House.
“Work him up,” she said softly, taking his arm. “Get lots of blood. I want this to be extensive. Find something we can fix, House.” She looked back but Wilson didn’t appear to be paying them any attention. “And do a full thyroid panel, not just the TSH test. I think, ”
“Yes, Dr. Cuddy! The endocrinologist thinks endocrine. I get it! I just may have done this before.”
“I know, but this is Wilson.”
“I know that, too,” he concluded, eager to move on from her hand-wringing worry. “Come on, Jimmy boy. You’re mine to have my wicked way with!”
* * *
“Oww!! God, you’ve got the finesse of a lumberjack, you know that!” Wilson barked as House plunged the vacutainer needle into his vein. Blood instantly began to pour forth, but House looked coolly into Wilson’s eyes with his jaw clenched, and yanked the needle out, pitching the whole tube into the sink.
“That’s it! Someone else can get your blood! You are done yelling at me, you got that! And hold that off! You’re bleeding down your arm, idiot!”
Wilson belatedly pressed two fingers in the crook of his arm and sat forward in his seat, breathing heavily, desperate to maintain some composure. It wasn’t to be. House turned away to find a band aid and when he swivelled back, hot tears were streaming down his friend’s face. He hadn’t seen those since Amber.
“I’m sorry,” he sobbed, unable to look at House. “I’m so dead tired, I just feel overwhelmed…I don’t know what’s going on or where all this hostility is coming from!”
Instantly ill at ease, but mindful of all this friendship had suffered, House made the supreme effort to step up to the plate this time rather than turn tail and run.
“It’s okay,” he said simply. He reached out and uncurled Wilson’s arm very gently, applying the band aid. “Let’s take one thing at a time and let me do the tests. It’s only overwhelming when you don’t have any answers, right?” His warm hand remained firmly on Wilson’s left arm and that one small gesture did not go unnoticed.
Smiling weakly, James sniffed and nodded. “Thanks. I’m okay. Self-control’s in short supply these days.”
“Tell me something I don’t already know; like symptoms, all of them, in order of appearance. And hop up on the exam table, open your shirt and loosen your pants. The clock’s ticking here and you’re only getting crankier!”
With no more discussion House proceeded to examine him from head to foot.
When it was clear he was finished with the physical, Wilson wordlessly extended his other arm for blood collection. House smirked, but held his tongue and gathered fresh supplies before he could change his mind.
“My God, House, I think I’m gonna need some orange juice before I get up from here. You took 9 vials!! I don’t remember saying I was donating blood at the same time!” Wilson communicated this more as an observation than a bad tempered complaint this time.
“Oh, suck it up. You can buy me an early lunch and get your juice then.”
“So what are you thinking? Out with it.” Wilson prompted, fatigue creeping back into his husky voice.
“What? You want me to hazard a guess before the blood work comes back?”
Wilson rolled his eyes as he pushed down his sleeves and moved on to the buttons on his shirt. “House, your worst guess is usually closer than anyone else’s expertise. You have to be thinking something.”
“So do you. You’re a doctor.”
He sighed in response, pinching the bridge of his nose. “You’d be surprised, House, and no smart ass remarks, either! Now that I’ve been confronted with this thing I realize I can’t remember the last time I had any energy or got up without aches and pains. I’m already depressed and having trouble concentrating. There’s nothing earth shattering in that. Besides, I’m painfully aware I’ve just had my fortieth birthday. I thought I was just slowing down, House. You know, getting older.”
“Good God, man. Speak for yourself! And you’re forty, not eighty! Besides what you just said, here’s what I see. Then we’ll play name that disease process!”
His leg was seriously complaining, so he hoisted himself up on the table beside Wilson before going on. “Your skin and hair are dull and dry. Your face is even paler than it usually is and there’s a discreet puffiness that wasn’t there about a week ago. You’re ridiculously cold even in reasonable environments. Your voice, even though you’ve been choosing to strain it a lot lately, is hoarse and thin. Your pulse, interestingly enough was sitting at 42 bpm. I took it twice.”
Wilson looked at House, beginning to pay attention.
“Admittedly that’s a resting heart rate, but I’ll wager if I had you up doing jumping jacks, it wouldn’t get much higher. And I saved the best for last.”
Turning to face the patient, their knees knocking each other, House reached for Wilson’s throat with both hands. Recoiling slightly, Wilson looked dubious until House began to run his fingers down the front of his throat, branching out and down over his Adam’s apple. “Tell me you didn’t notice this, genius?”
Wilson pushed House’s hands away so he could palpate his own throat. He looked at House with widening eyes as he realized his own fingers didn’t lie.
“Oh, crap. House it hasn’t been this swollen very long. I would have noticed when I was shaving, I’m sure. And I’m not having trouble swallowing. Well,” and he swallowed pointedly, “maybe just a little today.”
House rolled his eyes so far back in his head he made himself dizzy. “Cuddy, the endocrinologist gets a point for this one. We’ll know for sure when the labs come back, but we can probably blame all your socially unacceptable symptoms on hypothyroidism. That means levothyroxine for life, I’m afraid. We can pop pills together.”
Wilson was shaking his head. “It’s hard to believe. I mean, I have absolutely no family history,---”
“It’s less common by two thirds in men, but it’s the men who seem to be more prone to hostility and episodes of rage; that and the decreased libido, premature ejaculation and outright impotence. But unless my radar is off, you haven’t been getting any since….well, never mind. My bad.” He hopped off the table before Wilson could take a swing at him, verbally or otherwise.
James went back up to his office to catch up on some harmless paperwork. His staff was sidestepping him left and right and he felt so guilty even armed with a possible medical excuse, that he just pocketed his hands and looked at the floor. Once he had his diagnosis he would apologize to Catherine in person: with flowers, in fact. Yeah, it was the least he could do, he judged. Maybe chocolate, too…
Next day, Wilson woke feeling tired, achy and cranky as expected, but determined to keep a tight rein on his temper. He was anxious to get to work and see what his labs revealed. Though House had followed a trail of symptoms and physical findings to their most logical conclusion, they had not delved into possible reasons for those findings. Admittedly, oncologists think about cancer and Wilson could not entirely push away the idea that there could be a tumour on his thyroid. It was sobering to experience for himself a tiny bit of what every last one of his patients must go through.
Feeling like the eighty year old man House was trying not to compare him to, he shuffled to the bathroom, hand on his aching hip and feeling his throat for the now obviously inflamed thyroid gland. Knowing from recent experience that a hot shower would work temporary wonders, he let the hot water pulse over his back, shifting his stance to allow the spray to beat down on his tender hip.
When he had towelled himself off, he hoisted his blow dryer and styled his hair with practiced skill. His last cut was far too short to allow him to work any magic with it however, so he was done rather quickly. Ten minutes later he was out the door, promising himself something from the diner on the corner for breakfast. House would snatch the labs as soon as they were available online, so Wilson tried to concentrate on other things when he got to his office.
After a total of seven different pages that were about something other than his test results, Wilson sighed with relief when the pager went off one more time and he looked down to read, ‘Labs in, Cuddy’s office now, H.’
He was momentarily dismayed that he was going to get his results after Cuddy did for some reason, but he got over it and nearly sprinted to the elevators. Knocking, but not waiting for permission, he walked in and looked directed at House, then Cuddy, and back again. House sat on her comfy couch dangling his cane from one finger, his expression difficult to read, but James realized it could simply mean his results were as expected, and therefore boring.
Cuddy smiled warmly from her desk chair. “Morning, Wilson. How are you feeling?”
“Okay; about the same, really. You’ll be glad to know I haven’t read anyone the riot act today.” He adopted one of his goofier smiles and she laughed.
“Terrific. I’m proud of you.” She picked up the single sheet of paper before her without delay. “I know you’re anxious for these, so I’ll get right to it.”
Wilson sank into the chair opposite Cuddy.
“As we suspected, your results do point to hypothyroidism. Your cholesterol is quite elevated, your white cell count is up, as is your TSH and other thyroid indicators like T3 and T4.”
“Okay,” he nodded in an overly animated way. “I can live with that. It’s simple to treat. Anything else?” He glanced at House for any more clues, but he was actively engaged in leering down Cuddy’s blouse from the sidelines.
“Yes. You must be wondering why these symptoms would abruptly appear at this statistically early stage in your life. You are a bit young, after all for a simple endocrine problem to come along.”
Something nauseating that Wilson quickly recognized as dread, began to well up from the pit of his stomach and he actively felt any remaining colour leach out of his face.
“James? You look awful. Are you okay?” Cuddy stood and came around to him.
“Oh good God, woman!” House exploded. “You’re babbling away to an oncologist here!”
“Oh, Wilson, no no! I’m so sorry! It’s not lymphoma. It’s not thyroid cancer. Think autoimmune instead.” Cuddy soothed, placing her hand on his shoulder.
“What?” Wilson trained his anxious eyes upon House.
House stood and brushed past Cuddy with a quick, “You’re fired!”
“Wilson, you have Hashimoto’s thyroiditis.”
“The original autoimmune disease?” Wilson asked.
House nodded curtly. “That’s the one. Just because you don’t know of any relatives who’ve had it, doesn’t mean they weren’t carriers. We can check your DNA to confirm, but you have the antibodies against thyroid peroxidase in your blood. Cuddy included that test. She may suck at doctor speak, but she’s not too bad of an endocrinologist.”
“Oh, you two get out, then! Deal with it yourselves!” She sat behind her desk again and addressed only James.
“Wilson, I’m glad it’s something treatable. Get started on Levothyroxine today. You should begin to feel a lot better in a few days, but retest your drug levels in 14 days. Anything else, ask the great and terrible House.”
“Thanks, Cuddy,” Wilson tried for sincerity but amusement coloured his voice, and he rose quickly with House at his side.
“Well,” Wilson began as they fell into stride together in the hall.
“Go on,” prompted House, popping a Vicodin.
“I just have to wonder when my immune system decided to tank,” he explained.
“Seriously? Let’s see, there’s your girlfriend’s demise, your brother’s reappearance and untreated schizophrenia, there’s your depressing job which perpetually feeds off that need to be needed psyche of yours, and most importantly, there’s ME; your biggest responsibility! And I can probably overwhelm anyone’s immune system all by myself. You think?”
Wilson stopped and turned. He looked into House’s clear blue eyes, and no snappy comeback line came forth. House had said it. It was his way of acknowledging the burden of friendship he singularly placed upon Wilson. Friendship with Gregory House was not easy. He made a lousy friend in the traditional sense. But Wilson had recently decided he didn’t have much use for traditional. Almost every exciting thing he’d ever done in his adult life had been shared with House. And now House was looking back at him sharing a rare moment of transparency he would always remember.
But Wilson’s quiet realization of a ‘moment’ between them was suddenly making House wickedly uncomfortable, so he took pity on him with practiced deflection.
“Cuddy does suck when it comes to giving test results though, doesn’t she?” he said conspiratorily as they resumed their walk.
House gave a short burst of laughter. “Big time!”
Wilson reached over for his arm. “For a minute there I thought I was gonna die, and I’m the one that knows thyroid cancer can be cured!”
At this, House dissolved completely into a rare fit of giggles, pushing Wilson away and folding himself over his cane. For Wilson’s part, he stood back and admired his accomplishment, supremely pleased with himself.