Fic: Empathy Inc.
Title: Empathy, Inc.
Characters: House, Wilson, some Cuddy and OCs
Rating: PG
Words: 5K
Summary: Cuddy hires a company that provides 'empathy training' to doctors. House reacts. Set in an earlier season.
A/N: This idea came from an interview I did a couple months ago with the real-life doctor who started the first (only?) empathy-training program for doctors. I happened to blow my knee out last weekend, and since I'm trapped on my couch I decided to finally write it.
“Sooo.”
House would know those drawn-out vowels anywhere, so he didn’t bother to glance up from his manga. Displays of indifference never seemed to affect Wilson one way or the other, but House liked to use them anyway. It just felt good.
Wilson approached his desk then paused, presumably for the dramatic tension. House sighed and looked up.
“What?”
Wilson put his hands in his pockets and bounced on his heels ever so slightly. Nothing good could follow.
“Have you heard about Cuddy’s latest plan?” Wilson inquired with badly feigned innocence.
Yep, nothing good.
“Unless it involves dominatrix gear, I’m not interested.”
Wilson was clearly trying to suppress a grin. “Nooo.” He bounced a bit more. “She contracted with a company that provides”-Hands fanned, Broadway-style-“empathy training. For doctors. And department heads are first up.”
He paused and bit his lip, with a little twinkle in his eyes that said, You are so screwed.
“Huh.” House set down his comic. “There’s a training program in how to become a phony, manipulative sycophant?”
Wilson crossed his arms. “Yes. Human connection is so bogus.”
“There’s that. And the whole idea of empathy training is moronic. You’re either naturally touchy-feely or you’re not. Guess which camp I’m in?”
“Can I have a minute?” Wilson plopped down in the chair where a patient would sit if House talked to patients. “You really don’t think empathy can be learned? Studies suggest otherwise.”
House rolled his eyes. “Studies done by people who run empathy-training courses.”
Wilson nodded. “And trials testing cancer drugs are done by people who treat cancer.”
House leaned forward. “And your cancer drugs suck. Thank you for making my point.”
Wilson sighed. “You’re welcome. Of course, it doesn’t matter what you think about the science. Cuddy’s making the course mandatory. Legal’s all over it, apparently. They think it’ll cut down on malpractice claims.”
House scoffed. “How? Oh, I guess I should be mad you killed my daughter, but you just seem so sorry. Please.”
Wilson shrugged. “Believe it or not, patients like it when you give a crap. And yes, when bad things happen, they’re less likely to assume you were negligent.”
“You know what else patients like? Not dying.” House screwed up his face. “I’m not sure why, since life kinda sucks. But whatevs. I aim to please.”
Wilson smirked. “I know it’s hard for you to imagine there’s more than one truth. But you can save people’s lives and treat them with respect.”
House looked skyward in mock thoughtfulness. “I guess. But y’know, my method of treating them with medicine has worked really well. Being nice won’t save anyone’s life. If it did, you wouldn’t have so many dead patients.”
Wilson’s face clouded over, and House mentally winced. He probably shouldn’t have let that last line slip out. But he’d be damned if he’d acknowledge it.
Besides, Wilson quickly recovered his unflappable demeanor. “Well, you’ve got me there.”
He pushed to stand and gave House a pointed look. “And you may be partly right about the empathy thing, too. Some people may be incapable of learning it.”
Ah, the classic Wilsonian baiting technique. Only he would dare someone to be nice.
House couldn’t resist. “Care to wager?”
Wilson squinted. “Wait. You’re willing to bet that you can learn empathy, and thus negate your own theory that empathy can’t be learned?”
“Of course not.” House sat back and put his feet up on the desk. “I wanna bet that I can fake an empathic persona and have patients eat it up. Any self-respecting sociopath could do it. Thus proving that empathy is not a virtue. It’s just a thing. And for a lot of people, it’s a tool for manipulation.”
Hands went to hips. “Trying to understand what other people are going through, and responding to that, is just a form of manipulation?”
House made a sad face. “I know it must be hard for you to hear that. Do you wanna talk about it?”
Wilson pressed his lips together, and for a horrifying moment House thought he might say yes.
Luckily, Wilson just shook his head and turned on his heel. He did, however, pause in the doorway and look back with an evil smile. “Oh, by the way. It’s a weekend training. The good people at Empathics, Inc., will be here next Saturday, at 8 a.m. I’ll pick you up.”
*******
“You can’t force us to work on the weekend,” House proclaimed as he limp-barged into Cuddy’s office.
She held up an index finger and gave him the I’m on the phone face-which House had already deduced based upon the receiver pressed against her ear.
“Your bikini-wax appointment can wait,” he bitched. “Well, presumably. I’d need to see what’s going on down there to make an informed judgment.”
“Dr. Launer,” Cuddy said sweetly, as she shot eye daggers at House. “I’m sorry, but can I call you back? A psych patient is apparently roaming the hospital.”
She hung up, then clasped her hands on her desk and graced him with an annoyingly smug smile. “I guess Wilson told you about the empathy training?”
House aimed his cane at her. “What kind of sick game are you playing?”
Cuddy rolled her eyes, then began shuffling the no-doubt empty file folders she planted on her desk to imply work was being done. “The kind where patient care improves, and complaints go down, and lawsuits decline. I can see why you’re taking it personally.”
“Right.” House started pacing. “I don’t do much for patients. You keep me around strictly for my charm.”
“Not strictly,” Cuddy muttered. “News flash, House. You’re not the center of the universe, or even this hospital. This training is not about you.”
House pulled a face, and Cuddy held up a hand. “OK. Not only you. There are plenty of doctors here who lack a bedside manner. And this program works. There was a clinical trial published in Psychosomatic Medicine-”
“Oh, gawd.”
“It’s an excellent journal-” Cuddy stopped short and sighed. “You know what? Go away.” She flapped a hand at him. “I don’t have to justify this to you. The training is required. Suck it up.”
House leaned on his cane. “And if I don’t show, what’re you gonna do? Give me clinic duty? For which I won’t show?”
Cuddy grabbed a handful of phony files and stood up. “Nope. I’m counting on your curiosity.” She brushed past him before pausing and turning around. “I’m willing to bet you can’t pass up a chance to see what this research is all about.”
She flashed that knowing little smile again, and House was forced to admit (silently) she had a point.
“I already have a bet with Wilson,” he said lamely.
Cuddy stepped closer to pat him on the arm. “Good luck.”
As she strode out of the room, House craned his neck to get the maximum eyeful of booty. Somehow, though, it didn’t have the usual analgesic effect.
Empathy was already wreaking havoc on his life.
*******
“I knew there’d be an acronym,” House declared loudly as he and Wilson arrived at the auditorium.
He pointed to the screen behind the podium, where the word “EMPATHY” was displayed vertically, each letter corresponding to its very own platitude.
Wilson bobbed his head side to side. “Well, acronyms do aid in learning.”
House rolled his eyes. “God, are you a shill for this company?” He paused to ponder that. “Wait. You’d be the perfect poster-boy for this sham. The kindly oncologist with the legendary bedside manner. And if the patient’s cute enough, a great in-bed manner.”
Wilson looked at him sharply. “Not the place.”
House held up a hand. “Sorry. Was I being insensitive? I have no capacity for empathy, so…”
Wilson just stared for a moment, then shook his head. “C’mon. Let’s sit in the back. So when they throw you out, you won’t have far to limp.”
“Aww, you,” House cooed as he followed Wilson to the second-to-last row.
That was Wilson’s go-to seating for events like this. Sitting in the back row implied you couldn’t wait to get out-but the second-to-last row, just a couple seats in from the aisle, was less conspicuous.
And people think I’m the freaky one.
As they settled in, House began to read aloud from the screen. “E is for ‘Eye contact.’ Wow. Ground-breaking stuff.”
“And in your case, E should stand for ‘Entertain possibility of meeting patient.’”
“And in your case, E should mean ‘Eyebrows need plucking.’”
Wilson disengaged from the brilliant repartee to nod and smile at Martinelli from neurology, who was shuffling toward a seat a few rows in front of them.
She paused. “James. I almost didn’t recognize you without your lab coat and tie.” She laughed in a light, feminine way that House instantly despised.
“You haven’t seen him naked yet?” he asked incredulously. “Girl, get on that.”
Martinelli’s smile evaporated. “Oh. Hi, House.”
“Hi!”
Wilson nodded again as Martinelli continued on her way. “And this,” he declared, “is why I have no friends.”
“No one’s forcing you to sit here,” House pointed out. “Go ahead and join her.”
“Like you’d just let that happen.”
“Like you even want me to.”
Wilson sighed and looked back at the screen. “Let’s see if M is for ‘Murder.’”
House allowed a small smile as he returned his attention to mocking empathy. “M is for…‘Muscles of facial expression’? They’re really reaching on that one.”
“Yeah, that’s stupid,” Wilson agreed.
They were interrupted by Cuddy’s sudden appearance on the stage, as she marched to the podium in casual-Saturday three-inch heels, coffee in hand.
“God. Does the woman ever relax?” Wilson said sadly.
“Oh, trust me,” House replied with a leer.
Wilson offered an indulgent smile as Cuddy began to speak.
“Good morning, everyone,” she said smoothly. “And thank you for giving over your time to be here today.”
“You say that as if we had a choice,” House just couldn’t help calling out.
“I’m especially glad Dr. House could make it,” Cuddy continued without missing a beat. “As I was saying, I appreciate your presence here today, and I appreciate the great work you do, day in and day out.”
House valiantly bit his tongue as Cuddy droned on about the technological advances and “commitment to excellence” that had vastly improved the hospital’s “processes of care.”
Blah-blah, blahdity-blah-blah.
Finally, Cuddy got down to business. “I know that many of you do an outstanding job of communicating with your patients and addressing families’ emotional concerns.”
She glanced meaningfully in their direction, prompting Wilson to look down and shift in his seat. House pointed at himself and mouthed, “Me?”
“Unfortunately,” Cuddy went on, adopting her Serious Eyes, “for each of the past two years, we’ve seen an increase in grievances filed with the patient relations department.”
House could feel a collective eye-roll wash over the room. It was pretty awesome.
Cuddy held up a hand. “I realize that in many of those cases, the doctors and nurses were providing high-quality care. But the reality is, a good percentage of those complaints could be avoided if we were better at communicating with patients.”
“What percentage?” House demanded. Cuddy didn’t really think she could make data-less claims, did she?
“We’ll get to that, Dr. House,” Cuddy replied with a fake smile. “Actually,” she amended, addressing the room, “Dr. Ellen Schwartz will get to that. As you all know, Dr. Schwartz is here to talk about her groundbreaking research into the importance of empathy in patient care, and the benefits of empathy training. And those benefits are not just for patients, or for hospitals.”
She paused, presumably to heighten the drama. “They’re for you, too.”
House yawned as Cuddy smiled down at a woman sitting in the front row. “Dr. Schwartz, why don’t I hand this over to you?”
A slight woman with a Dorothy Hamill haircut and sensible gray pantsuit stood and exchanged places with Cuddy-though not before they shared a handshake full of phony fondness.
House slumped in his seat and groaned. There would be more endless babbling, but this time with no cleavage to take the edge off.
“Good morning, everyone,” Dr. Dorothy Hamill said, with a shy smile she probably thought was endearing. “I’m Ellen Schwartz, and I’m here today to talk about a topic that many of us might consider…well, squishy.”
Some polite chuckles followed, and House gripped his cane.
“But what I’d like to share with you,” Schwartz continued, “is what my colleagues and I-and other research teams-have learned about the neuroscience of empathy. And even more important to everyone in this room, we have evidence from a randomized, controlled trial that empathy training does impact our patients’ outcomes.”
House had to admit, this lady knew how to play to her audience.
“Empathy,” Schwartz proclaimed, “is not simply a feeling. Brain-imaging research shows it’s a complex construct that calls upon our capacity to reason, to make moral judgments, to alter our behavior, and to resonate with others emotionally.”
Wilson looked at him. “Huh. You can do a couple of those things.”
House feigned offense. “Why, Dr. Wilson. You’re showing a shocking lack of empathy for a crippled pain patient.”
Wilson smirked then opened his mouth to respond, but the bald guy from radiology-Ito? Cheeto?-turned around. “Do you mind?”
Wilson whispered a “sorry,” but House wasn’t in the mood for capitulation.
“Oh, please,” he scoffed. “Like you’re actually listening.”
“Uh, gentlemen?”
They all looked toward the stage, where Schwartz was gazing at them with that anxious little smile. “Is something wrong?” she inquired.
House glanced at Wilson, whose cheeks were predictably turning a lovely shade of “oh, shit.” Wilson returned the awkward smile and began to apologize-which just seemed unnecessary.
“Actually, yes, something’s wrong,” House piped up. “Empathy. It sucks.”
Wilson sighed. “Here we go.”
Schwartz laughed nervously, as Cuddy turned in her seat to shoot House a warning look-which he ignored. The woman had forced him to attend this charade, after all.
House faux-smiled at their guest of honor. “Since I knew you were coming, I spent the past few days perusing the empathy literature.”
“Oh,” Schwartz said tentatively. “That’s great.”
“I know,” House concurred. “But the thing about your randomized trial is, the outcomes you measured are worthless. You asked patients whether they thought their doctor had treated them respectfully.” He wrinkled his nose. “That’s not an outcome. That’s an opinion.”
Schwartz stood up straighter. “We measured hard outcomes, too,” she insisted, politely. “We looked at whether patients had better blood pressure control three months later. And the patients whose doctors underwent empathy training were doing better.”
House smirked. “The mean difference in systolic pressure between the groups was 1.2 points. Barely statistically significant. That’s your basis for selling an expensive, time-wasting training course?”
Schwartz put her hands on her hips, Wilson-style. “Dr…?”
“Yes,” House affirmed.
“House,” Cuddy supplied helpfully.
Schwartz nodded. “Dr. House. First of all, there’s a wealth of research on empathy, not just my trial. Beyond that, I strongly disagree that patients’ feelings are a worthless outcome.”
House shrugged. “We’re MDs, not life coaches. And if I insult your haircut during the course of saving your life, I’m pretty sure you’ll get over it.”
Schwartz lifted a hand to her hair, but quickly got back on track. “It’s not that simplistic, doctor. Other studies have found that patients who feel they’re being treated with respect are more likely to communicate important information. And they’re more likely to comply with their treatment regimens.”
“Dr. House,” Cuddy intoned as she swiveled around again. “Maybe we should let Dr. Schwartz present her findings before trying to discredit them.”
“I told you,” House said slowly. “I already read the literature.”
“OK,” Schwartz said, shaking her head and laughing softly. “Maybe I should get to my bullet points.”
House looked at Wilson. “Shit’s gettin’ real.”
Wilson nodded.
A moment later, the acronym on the screen was replaced with Bullet Points of Evidence. First up was “skin conductance monitoring.”
Schwartz cleared her throat. “We’ve used skin conductance monitoring during doctor-patient interactions to look at the concordance between their autonomic arousal.”
House made a “rowr” sound.
“Ohh-kay,” Wilson murmured.
“And what we’ve found,” Schwartz blathered on, “is that clinicians and patients are typically far apart in their nervous system activation during discussions. But after doctors undergo empathy training, they’re in much greater concordance with their patients.”
For Christ’s sake.
“And how is that a good thing?” House demanded. “You want us to dip to the level of the freaked-out moron with an STD? Ohmygod, you totally have the clap. What are we gonna tell your wife?”
He could see Ito/Cheeto’s shoulders shake with a poorly contained laugh. Not for the first time, he wondered why he was the only one willing to voice what everyone else was thinking.
It is my Dharma.
“No,” Schwartz replied evenly. “The skin conductance readings merely suggest that the doctor is, in fact, trying to imagine what the patient is feeling. But empathy doesn’t stop there. Then we have to use our reason, training and emotional intelligence to choose a response.”
“Or,” House cut in, “we could go straight to the reasoning part of the brain, and skip the Dr. Oz-related regions.”
“Dr. House, I’m not interested in pseudo-science, either,” Schwartz defended. “We have a large number of imaging studies looking at the neural underpinnings of empathy. We know, for instance, that the same neural centers that are active when we’re in pain can also be activated when we feel empathy for someone else in pain.”
“Again,” House pressed, “how is that good? Because people in pain can make really bad decisions. Or so I’ve heard.”
He could feel Wilson’s gaze, but ignored it. “And oh,” he added, holding his cane aloft, “some of us don’t really need our pain centers activated.”
Schwartz just stared, and an awkward silence fell over the room-until Wilson cleared his throat.
“Dr. House chairs our patient-relations committee, by the way,” he said smoothly, drawing a relieved-sounding group chuckle.
Cuddy took the opportunity to stand up and address the audience. “Everyone, I think it would be best if we let Dr. Schwartz talk about her research and then have a Q-and-A at the end. We do have to get to the actual training, too,” she added with a tight smile.
“Hey, Schwartz,” House forged on, “are you aware of the work by a Dr. Cheng at the University of Chicago?”
Cuddy glared as Schwartz responded, “Oh, yes. Of course.”
“Then you know she’s found little correlation between doctors’ level of empathy and their patients’ outcomes. And oddly, her research suggests that some of the best doctors purposely ‘down-regulate’ their empathy capacity, so they can focus on using the actually productive parts of their brains.”
“That’s based on a small sample of doctors from one medical center,” Schwartz objected.
“So is your study.” House grinned. “You might also be aware of the many experiments where people have been induced to feel deep empathy for someone else’s pain. The result is, they then make really illogical, self-sacrificing decisions. In other words, they become dumber.”
Schwartz crossed her arms. “Now, Dr. House, I’m sure you know that in the real world, people would generally do that only if someone they love is in pain. A doctor who empathizes with patients would still have the emotional distance to make sound, rational decisions.”
House furrowed his brow. “You’re giving this room of idiots a lot of credit.”
A hand went up in the second row, and House saw that it belonged to the blonde-Rinella? Nutella?-who ran the ER. “I’d just like to preface this by saying, I’m not siding with House,” she clarified. “But how relevant is all of this in a hospital setting? When I get a GSW, I assume the patient’s in pain, and I don’t really have time to feel it.”
Schwartz nodded enthusiastically. “Oh, that’s an excellent point.”
House rolled his eyes.
“First,” Schwartz continued, “I think compassionate care is always relevant. But yes, of course, your relationship with an emergent patient is much different from a longer-term doctor-patient relationship-in oncology, for instance.”
House couldn’t help a genuine smile. Awesome.
He shot his hand up. “Oo-oo! Dr. Wilson here is head of oncology. He also chairs our wooby committee.”
Wilson exhaled heavily-and then after a few moments of silence, made his Confused Face. “Oh. Do you want me to say something?” he asked Schwartz.
Once again, Cuddy stepped in. “Dr. Wilson actually already trains his staff in how to communicate in plain English. And how to…broach sensitive subjects.”
“He’s a pioneer in the field of telling people they’re toast,” House agreed.
Wilson’s jaw tensed, which was always pleasing.
Schwartz smiled warmly. “Dr. Wilson, it’s great to hear that you take communication seriously.” She glanced pointedly at House.
Wilson scratched at an eyebrow. “Well, like you said, in oncology we could be seeing a patient and their family for years.”
Schwartz kept smiling, to the point of looking deranged. “Would you mind sharing some of what you do in your training?”
Wilson huffed a little laugh. “It’s not really a training. I just…talk to my staff about some small things we can do to make people more comfortable. You know. Like sitting by the patient’s bed, instead of standing over them with a chart, looking at your watch.”
“Excellent,” Schwartz approved. “That’s one of the steps we advise.”
“Wow!” House interjected. “But he’s got more than that. Really, he almost has empathy down to a script.”
Wilson cast him a withering glare. “I would hardly say that.”
House nodded then looked at Schwartz. “Maybe script isn’t the word. It’s more like a flow chart. Dr. Wilson diligently maps out how to emotionally proceed with different types of patients.”
Schwartz returned the nod. “And that’s great. One of the ideas of empathy training is to give doctors some guidelines on how to handle the emotional side of care.”
“Fantastic,” House chirped. “So let’s just be honest about what we’re doing here. You talk about skin conductance tracings and brain imaging, and pretend an afternoon with you will reconnect us with our compassionate hearts.”
He paused to clasp his hands in rapture, then let them drop.
“But really, you’re just gonna give us handy tips on how to look like we care and then manipulate people. So they’ll feel like they just saw a competent doctor. And give high patient satisfaction ratings. And maybe not sue when they find out their nice doctor wasn’t all that. But are they really better off?”
Wilson turned to him. His face was impassive, but House could see the flash of anger in his eyes. “I do not pretend to care.”
House screwed up his face. “I never said you did.”
He returned his attention to Schwartz. “There’s a funny thing about emotional intelligence: It’s a hallmark of the sociopath. Control your emotions, put on a good face, get people to trust you. And then, Bam!”-Half the room flinched-“Meat cleaver to the head…Or convince a patient to do chemo. Whichever.”
Schwartz crossed her arms. “Emotional intelligence is also a hallmark of the compassionate person who honestly wants to help others.”
“Agreed.” House shrugged. “But it’s a fallacy to assume that the doctor who appears empathetic is innately better, and then try to train us all to look and sound and act just like him.”
He hooked a thumb toward Wilson. “He might look like a big teddy bear, but I wouldn’t be surprised if Dr. Wilson snapped and took the clinic hostage one day.”
Ito/Cheeto turned around. “Neither would we, House.”
House almost smiled. This guy wasn’t bad. Maybe he and Wilson should invite him out for a beer.
“Dr. House,” Schwartz said, shaking her head. “I’m confused. Is your argument that this training could turn doctors into emotional wrecks who can’t use their reason, or that it creates a bunch of manipulative phonies?”
House furrowed his brow. “Can’t I have more than one argument? That’s kinda my thing.”
Wilson pinched the bridge of his nose briefly, then looked up, toward the stage. “The way we talk to patients matters,” he said simply.
“Sure,” House conceded. “But in the end, how much does it matter?”
Wilson kept his gaze straight ahead. “If you mean the end end, I have no idea. But I know it matters.”
Cuddy stood again and straightened her suit jacket-a sure sign she meant business this time. “OK, people. This is how the rest of the morning will go. Dr. Schwartz will get to finish her presentation, and then we’ll have a friendly discussion. Got it?”
There was a group murmur reminiscent of third grade, but House couldn’t fully relish it. He was peering at Wilson, who was still staring dead-ahead.
He decided to test the waters. “I’m sooo in trouble when we get home, aren’t I?”
Wilson pressed his lips together before speaking. “Just…shut up for a while.”
House nodded. He could probably do that. For a while.
*******
House retreated to his office for the lunch break, because he could stand only so much group activity. Plus, that’s where he’d stashed the two chocolate-chunk brownies Wilson had picked up that morning. One might have been intended for Wilson, but he wasn’t sure.
As if on cue, the man appeared in the hallway and House mentally cursed as he stalked in. “Oh,” Wilson said, in that way of his. “That’s where my brownie went.”
“How long did it take to piece that puzzle together?”
Wilson said nothing, making a beeline for the second brownie perched on the desk. House almost felt bad as he grabbed it and took a huge bite.
“You never stood a chance,” he proclaimed, through a mouthful of deliciousness.
Wilson stared, seemingly in disbelief-though House couldn’t imagine why. After a moment, Wilson flopped into the chair in front of the desk.
“Well,” he said in defeat. “I guess I deserved that, for buying them.”
House just chewed and waited, while Wilson chewed on his lip and waited.
The standoff didn’t last long. “Do you,” Wilson began, hesitantly, “really think I pretend to care?”
House shook his head. “No. I told you, I didn’t say that.”
Wilson raised an eyebrow, so House continued. “I do think some of your staff are phoning it in. I’ve seen Brown do the hand-on-shoulder thing. He looks like he’s handling hazardous waste. Kinda creepy.”
Wilson nodded. “Yes, well, I know you don’t like to creep patients out.”
House returned the nod.
Wilson leaned forward and put his elbows on his knees. “I don’t set parameters so I can-so we can-look like we care. Having some guidelines protects everyone. It helps keep us from getting too drawn into the moment, and…”
He gestured vaguely.
“I know,” House said, putting his feet up on the desk. “I’ve seen what happens when you get too emotionally involved with a patient.”
Wilson worked his jaw for a moment. “It’s not just that, House.” He sighed. “You can so easily get attached, and then…Sometimes it’s better to detach a little and fall back on ‘sit by the bed, put a hand on his hand.’ I know you look down on that, but-”
“No, I don’t,” House corrected.
Wilson blinked. “You don’t…OK. Then why did you call me out down there?”
“I didn’t. I was calling her out.” At Wilson’s confused expression, he shrugged. “You already do this stuff, without trying to commodify it. And generally speaking, I have a problem with anyone who cherry-picks scientific evidence and tries to make a quick buck.”
House leaned back and looked at the ceiling for his next admission. “I don’t look down on what you do.”
After a beat, he glanced at Wilson, who appeared to be digesting that information. House took the opportunity to polish off the brownie.
“Fair enough,” Wilson replied. “But I have my own problem.”
“There’s no way you have just one,” House objected, spewing brownie crumbs.
Wilson held up his hands. “Well, this is the most pressing one right now. I’m wondering what a doctor gains from pretending to not care.”
Oh, gawd. Of course.
“I do not pretend,” House argued in a high-pitched whine.
Wilson wagged an index finger. “First of all, that sounds nothing like me. Secondly, you totally pretend. I mean, sometimes you do. I’ve caught you caring when you think no one’s looking.”
House rolled his eyes. “I dunno. I guess I need to protect myself,” he said with a pout. “My real problem is, I just feel so much.”
Wilson regarded him with an odd little smile that made House want to punch him.
He swung his legs off the desk. “My neural pain centers can only handle so much stimulation,” he continued as he limped to hover over Wilson. “I can’t take on other people’s pain, too. Don’t you see?”
Wilson just kept looking at him, until House started to grow agitated.
“I see,” Wilson finally affirmed.
“At last, someone sees me,” House sneered.
The odd smile returned and House gripped his cane, mentally willing Wilson to cease and desist before he was forced to stimulate the bastard’s neural pain centers.
Luckily, Wilson seemed to sense the threat. “C’mon,” he said, pushing to his feet. “We better get back.”
House gaped at him. “You think I’m going back? This place does have doors leading outside, you know.”
Wilson shrugged. “But the fun part is still ahead. Imagine all the opportunities for ridicule when we do the actual training.”
House paused to consider that, and Wilson leaned in, “You know there’s gonna be role-playing, right?”
House’s eyebrows shot up. “You think Cuddy will play the naughty nurse?”
Wilson did his head-tilt thing. “I somehow doubt it.”
House nodded in disappointment, but quickly brightened at his next thought. “Will you?”
Wilson smiled again, but this one was more…coy? “You never know.”
House studied him. “You think this training is as bogus as I do, don’t you?”
Wilson bit his lip. “I think you’re right about Schwartz. But I also think…I think what she’s doing still has merit.”
“Wow,” House deadpanned. “That’s so decisive.”
“Human interaction is messy, I hear.”
“That’s probably why I limit my time with the humans,” House remarked as they began to amble out of his office.
“Except me,” Wilson murmured, keeping his head down.
For once, House had no argument.
“Except you.”
-End
Characters: House, Wilson, some Cuddy and OCs
Rating: PG
Words: 5K
Summary: Cuddy hires a company that provides 'empathy training' to doctors. House reacts. Set in an earlier season.
A/N: This idea came from an interview I did a couple months ago with the real-life doctor who started the first (only?) empathy-training program for doctors. I happened to blow my knee out last weekend, and since I'm trapped on my couch I decided to finally write it.
“Sooo.”
House would know those drawn-out vowels anywhere, so he didn’t bother to glance up from his manga. Displays of indifference never seemed to affect Wilson one way or the other, but House liked to use them anyway. It just felt good.
Wilson approached his desk then paused, presumably for the dramatic tension. House sighed and looked up.
“What?”
Wilson put his hands in his pockets and bounced on his heels ever so slightly. Nothing good could follow.
“Have you heard about Cuddy’s latest plan?” Wilson inquired with badly feigned innocence.
Yep, nothing good.
“Unless it involves dominatrix gear, I’m not interested.”
Wilson was clearly trying to suppress a grin. “Nooo.” He bounced a bit more. “She contracted with a company that provides”-Hands fanned, Broadway-style-“empathy training. For doctors. And department heads are first up.”
He paused and bit his lip, with a little twinkle in his eyes that said, You are so screwed.
“Huh.” House set down his comic. “There’s a training program in how to become a phony, manipulative sycophant?”
Wilson crossed his arms. “Yes. Human connection is so bogus.”
“There’s that. And the whole idea of empathy training is moronic. You’re either naturally touchy-feely or you’re not. Guess which camp I’m in?”
“Can I have a minute?” Wilson plopped down in the chair where a patient would sit if House talked to patients. “You really don’t think empathy can be learned? Studies suggest otherwise.”
House rolled his eyes. “Studies done by people who run empathy-training courses.”
Wilson nodded. “And trials testing cancer drugs are done by people who treat cancer.”
House leaned forward. “And your cancer drugs suck. Thank you for making my point.”
Wilson sighed. “You’re welcome. Of course, it doesn’t matter what you think about the science. Cuddy’s making the course mandatory. Legal’s all over it, apparently. They think it’ll cut down on malpractice claims.”
House scoffed. “How? Oh, I guess I should be mad you killed my daughter, but you just seem so sorry. Please.”
Wilson shrugged. “Believe it or not, patients like it when you give a crap. And yes, when bad things happen, they’re less likely to assume you were negligent.”
“You know what else patients like? Not dying.” House screwed up his face. “I’m not sure why, since life kinda sucks. But whatevs. I aim to please.”
Wilson smirked. “I know it’s hard for you to imagine there’s more than one truth. But you can save people’s lives and treat them with respect.”
House looked skyward in mock thoughtfulness. “I guess. But y’know, my method of treating them with medicine has worked really well. Being nice won’t save anyone’s life. If it did, you wouldn’t have so many dead patients.”
Wilson’s face clouded over, and House mentally winced. He probably shouldn’t have let that last line slip out. But he’d be damned if he’d acknowledge it.
Besides, Wilson quickly recovered his unflappable demeanor. “Well, you’ve got me there.”
He pushed to stand and gave House a pointed look. “And you may be partly right about the empathy thing, too. Some people may be incapable of learning it.”
Ah, the classic Wilsonian baiting technique. Only he would dare someone to be nice.
House couldn’t resist. “Care to wager?”
Wilson squinted. “Wait. You’re willing to bet that you can learn empathy, and thus negate your own theory that empathy can’t be learned?”
“Of course not.” House sat back and put his feet up on the desk. “I wanna bet that I can fake an empathic persona and have patients eat it up. Any self-respecting sociopath could do it. Thus proving that empathy is not a virtue. It’s just a thing. And for a lot of people, it’s a tool for manipulation.”
Hands went to hips. “Trying to understand what other people are going through, and responding to that, is just a form of manipulation?”
House made a sad face. “I know it must be hard for you to hear that. Do you wanna talk about it?”
Wilson pressed his lips together, and for a horrifying moment House thought he might say yes.
Luckily, Wilson just shook his head and turned on his heel. He did, however, pause in the doorway and look back with an evil smile. “Oh, by the way. It’s a weekend training. The good people at Empathics, Inc., will be here next Saturday, at 8 a.m. I’ll pick you up.”
*******
“You can’t force us to work on the weekend,” House proclaimed as he limp-barged into Cuddy’s office.
She held up an index finger and gave him the I’m on the phone face-which House had already deduced based upon the receiver pressed against her ear.
“Your bikini-wax appointment can wait,” he bitched. “Well, presumably. I’d need to see what’s going on down there to make an informed judgment.”
“Dr. Launer,” Cuddy said sweetly, as she shot eye daggers at House. “I’m sorry, but can I call you back? A psych patient is apparently roaming the hospital.”
She hung up, then clasped her hands on her desk and graced him with an annoyingly smug smile. “I guess Wilson told you about the empathy training?”
House aimed his cane at her. “What kind of sick game are you playing?”
Cuddy rolled her eyes, then began shuffling the no-doubt empty file folders she planted on her desk to imply work was being done. “The kind where patient care improves, and complaints go down, and lawsuits decline. I can see why you’re taking it personally.”
“Right.” House started pacing. “I don’t do much for patients. You keep me around strictly for my charm.”
“Not strictly,” Cuddy muttered. “News flash, House. You’re not the center of the universe, or even this hospital. This training is not about you.”
House pulled a face, and Cuddy held up a hand. “OK. Not only you. There are plenty of doctors here who lack a bedside manner. And this program works. There was a clinical trial published in Psychosomatic Medicine-”
“Oh, gawd.”
“It’s an excellent journal-” Cuddy stopped short and sighed. “You know what? Go away.” She flapped a hand at him. “I don’t have to justify this to you. The training is required. Suck it up.”
House leaned on his cane. “And if I don’t show, what’re you gonna do? Give me clinic duty? For which I won’t show?”
Cuddy grabbed a handful of phony files and stood up. “Nope. I’m counting on your curiosity.” She brushed past him before pausing and turning around. “I’m willing to bet you can’t pass up a chance to see what this research is all about.”
She flashed that knowing little smile again, and House was forced to admit (silently) she had a point.
“I already have a bet with Wilson,” he said lamely.
Cuddy stepped closer to pat him on the arm. “Good luck.”
As she strode out of the room, House craned his neck to get the maximum eyeful of booty. Somehow, though, it didn’t have the usual analgesic effect.
Empathy was already wreaking havoc on his life.
*******
“I knew there’d be an acronym,” House declared loudly as he and Wilson arrived at the auditorium.
He pointed to the screen behind the podium, where the word “EMPATHY” was displayed vertically, each letter corresponding to its very own platitude.
Wilson bobbed his head side to side. “Well, acronyms do aid in learning.”
House rolled his eyes. “God, are you a shill for this company?” He paused to ponder that. “Wait. You’d be the perfect poster-boy for this sham. The kindly oncologist with the legendary bedside manner. And if the patient’s cute enough, a great in-bed manner.”
Wilson looked at him sharply. “Not the place.”
House held up a hand. “Sorry. Was I being insensitive? I have no capacity for empathy, so…”
Wilson just stared for a moment, then shook his head. “C’mon. Let’s sit in the back. So when they throw you out, you won’t have far to limp.”
“Aww, you,” House cooed as he followed Wilson to the second-to-last row.
That was Wilson’s go-to seating for events like this. Sitting in the back row implied you couldn’t wait to get out-but the second-to-last row, just a couple seats in from the aisle, was less conspicuous.
And people think I’m the freaky one.
As they settled in, House began to read aloud from the screen. “E is for ‘Eye contact.’ Wow. Ground-breaking stuff.”
“And in your case, E should stand for ‘Entertain possibility of meeting patient.’”
“And in your case, E should mean ‘Eyebrows need plucking.’”
Wilson disengaged from the brilliant repartee to nod and smile at Martinelli from neurology, who was shuffling toward a seat a few rows in front of them.
She paused. “James. I almost didn’t recognize you without your lab coat and tie.” She laughed in a light, feminine way that House instantly despised.
“You haven’t seen him naked yet?” he asked incredulously. “Girl, get on that.”
Martinelli’s smile evaporated. “Oh. Hi, House.”
“Hi!”
Wilson nodded again as Martinelli continued on her way. “And this,” he declared, “is why I have no friends.”
“No one’s forcing you to sit here,” House pointed out. “Go ahead and join her.”
“Like you’d just let that happen.”
“Like you even want me to.”
Wilson sighed and looked back at the screen. “Let’s see if M is for ‘Murder.’”
House allowed a small smile as he returned his attention to mocking empathy. “M is for…‘Muscles of facial expression’? They’re really reaching on that one.”
“Yeah, that’s stupid,” Wilson agreed.
They were interrupted by Cuddy’s sudden appearance on the stage, as she marched to the podium in casual-Saturday three-inch heels, coffee in hand.
“God. Does the woman ever relax?” Wilson said sadly.
“Oh, trust me,” House replied with a leer.
Wilson offered an indulgent smile as Cuddy began to speak.
“Good morning, everyone,” she said smoothly. “And thank you for giving over your time to be here today.”
“You say that as if we had a choice,” House just couldn’t help calling out.
“I’m especially glad Dr. House could make it,” Cuddy continued without missing a beat. “As I was saying, I appreciate your presence here today, and I appreciate the great work you do, day in and day out.”
House valiantly bit his tongue as Cuddy droned on about the technological advances and “commitment to excellence” that had vastly improved the hospital’s “processes of care.”
Blah-blah, blahdity-blah-blah.
Finally, Cuddy got down to business. “I know that many of you do an outstanding job of communicating with your patients and addressing families’ emotional concerns.”
She glanced meaningfully in their direction, prompting Wilson to look down and shift in his seat. House pointed at himself and mouthed, “Me?”
“Unfortunately,” Cuddy went on, adopting her Serious Eyes, “for each of the past two years, we’ve seen an increase in grievances filed with the patient relations department.”
House could feel a collective eye-roll wash over the room. It was pretty awesome.
Cuddy held up a hand. “I realize that in many of those cases, the doctors and nurses were providing high-quality care. But the reality is, a good percentage of those complaints could be avoided if we were better at communicating with patients.”
“What percentage?” House demanded. Cuddy didn’t really think she could make data-less claims, did she?
“We’ll get to that, Dr. House,” Cuddy replied with a fake smile. “Actually,” she amended, addressing the room, “Dr. Ellen Schwartz will get to that. As you all know, Dr. Schwartz is here to talk about her groundbreaking research into the importance of empathy in patient care, and the benefits of empathy training. And those benefits are not just for patients, or for hospitals.”
She paused, presumably to heighten the drama. “They’re for you, too.”
House yawned as Cuddy smiled down at a woman sitting in the front row. “Dr. Schwartz, why don’t I hand this over to you?”
A slight woman with a Dorothy Hamill haircut and sensible gray pantsuit stood and exchanged places with Cuddy-though not before they shared a handshake full of phony fondness.
House slumped in his seat and groaned. There would be more endless babbling, but this time with no cleavage to take the edge off.
“Good morning, everyone,” Dr. Dorothy Hamill said, with a shy smile she probably thought was endearing. “I’m Ellen Schwartz, and I’m here today to talk about a topic that many of us might consider…well, squishy.”
Some polite chuckles followed, and House gripped his cane.
“But what I’d like to share with you,” Schwartz continued, “is what my colleagues and I-and other research teams-have learned about the neuroscience of empathy. And even more important to everyone in this room, we have evidence from a randomized, controlled trial that empathy training does impact our patients’ outcomes.”
House had to admit, this lady knew how to play to her audience.
“Empathy,” Schwartz proclaimed, “is not simply a feeling. Brain-imaging research shows it’s a complex construct that calls upon our capacity to reason, to make moral judgments, to alter our behavior, and to resonate with others emotionally.”
Wilson looked at him. “Huh. You can do a couple of those things.”
House feigned offense. “Why, Dr. Wilson. You’re showing a shocking lack of empathy for a crippled pain patient.”
Wilson smirked then opened his mouth to respond, but the bald guy from radiology-Ito? Cheeto?-turned around. “Do you mind?”
Wilson whispered a “sorry,” but House wasn’t in the mood for capitulation.
“Oh, please,” he scoffed. “Like you’re actually listening.”
“Uh, gentlemen?”
They all looked toward the stage, where Schwartz was gazing at them with that anxious little smile. “Is something wrong?” she inquired.
House glanced at Wilson, whose cheeks were predictably turning a lovely shade of “oh, shit.” Wilson returned the awkward smile and began to apologize-which just seemed unnecessary.
“Actually, yes, something’s wrong,” House piped up. “Empathy. It sucks.”
Wilson sighed. “Here we go.”
Schwartz laughed nervously, as Cuddy turned in her seat to shoot House a warning look-which he ignored. The woman had forced him to attend this charade, after all.
House faux-smiled at their guest of honor. “Since I knew you were coming, I spent the past few days perusing the empathy literature.”
“Oh,” Schwartz said tentatively. “That’s great.”
“I know,” House concurred. “But the thing about your randomized trial is, the outcomes you measured are worthless. You asked patients whether they thought their doctor had treated them respectfully.” He wrinkled his nose. “That’s not an outcome. That’s an opinion.”
Schwartz stood up straighter. “We measured hard outcomes, too,” she insisted, politely. “We looked at whether patients had better blood pressure control three months later. And the patients whose doctors underwent empathy training were doing better.”
House smirked. “The mean difference in systolic pressure between the groups was 1.2 points. Barely statistically significant. That’s your basis for selling an expensive, time-wasting training course?”
Schwartz put her hands on her hips, Wilson-style. “Dr…?”
“Yes,” House affirmed.
“House,” Cuddy supplied helpfully.
Schwartz nodded. “Dr. House. First of all, there’s a wealth of research on empathy, not just my trial. Beyond that, I strongly disagree that patients’ feelings are a worthless outcome.”
House shrugged. “We’re MDs, not life coaches. And if I insult your haircut during the course of saving your life, I’m pretty sure you’ll get over it.”
Schwartz lifted a hand to her hair, but quickly got back on track. “It’s not that simplistic, doctor. Other studies have found that patients who feel they’re being treated with respect are more likely to communicate important information. And they’re more likely to comply with their treatment regimens.”
“Dr. House,” Cuddy intoned as she swiveled around again. “Maybe we should let Dr. Schwartz present her findings before trying to discredit them.”
“I told you,” House said slowly. “I already read the literature.”
“OK,” Schwartz said, shaking her head and laughing softly. “Maybe I should get to my bullet points.”
House looked at Wilson. “Shit’s gettin’ real.”
Wilson nodded.
A moment later, the acronym on the screen was replaced with Bullet Points of Evidence. First up was “skin conductance monitoring.”
Schwartz cleared her throat. “We’ve used skin conductance monitoring during doctor-patient interactions to look at the concordance between their autonomic arousal.”
House made a “rowr” sound.
“Ohh-kay,” Wilson murmured.
“And what we’ve found,” Schwartz blathered on, “is that clinicians and patients are typically far apart in their nervous system activation during discussions. But after doctors undergo empathy training, they’re in much greater concordance with their patients.”
For Christ’s sake.
“And how is that a good thing?” House demanded. “You want us to dip to the level of the freaked-out moron with an STD? Ohmygod, you totally have the clap. What are we gonna tell your wife?”
He could see Ito/Cheeto’s shoulders shake with a poorly contained laugh. Not for the first time, he wondered why he was the only one willing to voice what everyone else was thinking.
It is my Dharma.
“No,” Schwartz replied evenly. “The skin conductance readings merely suggest that the doctor is, in fact, trying to imagine what the patient is feeling. But empathy doesn’t stop there. Then we have to use our reason, training and emotional intelligence to choose a response.”
“Or,” House cut in, “we could go straight to the reasoning part of the brain, and skip the Dr. Oz-related regions.”
“Dr. House, I’m not interested in pseudo-science, either,” Schwartz defended. “We have a large number of imaging studies looking at the neural underpinnings of empathy. We know, for instance, that the same neural centers that are active when we’re in pain can also be activated when we feel empathy for someone else in pain.”
“Again,” House pressed, “how is that good? Because people in pain can make really bad decisions. Or so I’ve heard.”
He could feel Wilson’s gaze, but ignored it. “And oh,” he added, holding his cane aloft, “some of us don’t really need our pain centers activated.”
Schwartz just stared, and an awkward silence fell over the room-until Wilson cleared his throat.
“Dr. House chairs our patient-relations committee, by the way,” he said smoothly, drawing a relieved-sounding group chuckle.
Cuddy took the opportunity to stand up and address the audience. “Everyone, I think it would be best if we let Dr. Schwartz talk about her research and then have a Q-and-A at the end. We do have to get to the actual training, too,” she added with a tight smile.
“Hey, Schwartz,” House forged on, “are you aware of the work by a Dr. Cheng at the University of Chicago?”
Cuddy glared as Schwartz responded, “Oh, yes. Of course.”
“Then you know she’s found little correlation between doctors’ level of empathy and their patients’ outcomes. And oddly, her research suggests that some of the best doctors purposely ‘down-regulate’ their empathy capacity, so they can focus on using the actually productive parts of their brains.”
“That’s based on a small sample of doctors from one medical center,” Schwartz objected.
“So is your study.” House grinned. “You might also be aware of the many experiments where people have been induced to feel deep empathy for someone else’s pain. The result is, they then make really illogical, self-sacrificing decisions. In other words, they become dumber.”
Schwartz crossed her arms. “Now, Dr. House, I’m sure you know that in the real world, people would generally do that only if someone they love is in pain. A doctor who empathizes with patients would still have the emotional distance to make sound, rational decisions.”
House furrowed his brow. “You’re giving this room of idiots a lot of credit.”
A hand went up in the second row, and House saw that it belonged to the blonde-Rinella? Nutella?-who ran the ER. “I’d just like to preface this by saying, I’m not siding with House,” she clarified. “But how relevant is all of this in a hospital setting? When I get a GSW, I assume the patient’s in pain, and I don’t really have time to feel it.”
Schwartz nodded enthusiastically. “Oh, that’s an excellent point.”
House rolled his eyes.
“First,” Schwartz continued, “I think compassionate care is always relevant. But yes, of course, your relationship with an emergent patient is much different from a longer-term doctor-patient relationship-in oncology, for instance.”
House couldn’t help a genuine smile. Awesome.
He shot his hand up. “Oo-oo! Dr. Wilson here is head of oncology. He also chairs our wooby committee.”
Wilson exhaled heavily-and then after a few moments of silence, made his Confused Face. “Oh. Do you want me to say something?” he asked Schwartz.
Once again, Cuddy stepped in. “Dr. Wilson actually already trains his staff in how to communicate in plain English. And how to…broach sensitive subjects.”
“He’s a pioneer in the field of telling people they’re toast,” House agreed.
Wilson’s jaw tensed, which was always pleasing.
Schwartz smiled warmly. “Dr. Wilson, it’s great to hear that you take communication seriously.” She glanced pointedly at House.
Wilson scratched at an eyebrow. “Well, like you said, in oncology we could be seeing a patient and their family for years.”
Schwartz kept smiling, to the point of looking deranged. “Would you mind sharing some of what you do in your training?”
Wilson huffed a little laugh. “It’s not really a training. I just…talk to my staff about some small things we can do to make people more comfortable. You know. Like sitting by the patient’s bed, instead of standing over them with a chart, looking at your watch.”
“Excellent,” Schwartz approved. “That’s one of the steps we advise.”
“Wow!” House interjected. “But he’s got more than that. Really, he almost has empathy down to a script.”
Wilson cast him a withering glare. “I would hardly say that.”
House nodded then looked at Schwartz. “Maybe script isn’t the word. It’s more like a flow chart. Dr. Wilson diligently maps out how to emotionally proceed with different types of patients.”
Schwartz returned the nod. “And that’s great. One of the ideas of empathy training is to give doctors some guidelines on how to handle the emotional side of care.”
“Fantastic,” House chirped. “So let’s just be honest about what we’re doing here. You talk about skin conductance tracings and brain imaging, and pretend an afternoon with you will reconnect us with our compassionate hearts.”
He paused to clasp his hands in rapture, then let them drop.
“But really, you’re just gonna give us handy tips on how to look like we care and then manipulate people. So they’ll feel like they just saw a competent doctor. And give high patient satisfaction ratings. And maybe not sue when they find out their nice doctor wasn’t all that. But are they really better off?”
Wilson turned to him. His face was impassive, but House could see the flash of anger in his eyes. “I do not pretend to care.”
House screwed up his face. “I never said you did.”
He returned his attention to Schwartz. “There’s a funny thing about emotional intelligence: It’s a hallmark of the sociopath. Control your emotions, put on a good face, get people to trust you. And then, Bam!”-Half the room flinched-“Meat cleaver to the head…Or convince a patient to do chemo. Whichever.”
Schwartz crossed her arms. “Emotional intelligence is also a hallmark of the compassionate person who honestly wants to help others.”
“Agreed.” House shrugged. “But it’s a fallacy to assume that the doctor who appears empathetic is innately better, and then try to train us all to look and sound and act just like him.”
He hooked a thumb toward Wilson. “He might look like a big teddy bear, but I wouldn’t be surprised if Dr. Wilson snapped and took the clinic hostage one day.”
Ito/Cheeto turned around. “Neither would we, House.”
House almost smiled. This guy wasn’t bad. Maybe he and Wilson should invite him out for a beer.
“Dr. House,” Schwartz said, shaking her head. “I’m confused. Is your argument that this training could turn doctors into emotional wrecks who can’t use their reason, or that it creates a bunch of manipulative phonies?”
House furrowed his brow. “Can’t I have more than one argument? That’s kinda my thing.”
Wilson pinched the bridge of his nose briefly, then looked up, toward the stage. “The way we talk to patients matters,” he said simply.
“Sure,” House conceded. “But in the end, how much does it matter?”
Wilson kept his gaze straight ahead. “If you mean the end end, I have no idea. But I know it matters.”
Cuddy stood again and straightened her suit jacket-a sure sign she meant business this time. “OK, people. This is how the rest of the morning will go. Dr. Schwartz will get to finish her presentation, and then we’ll have a friendly discussion. Got it?”
There was a group murmur reminiscent of third grade, but House couldn’t fully relish it. He was peering at Wilson, who was still staring dead-ahead.
He decided to test the waters. “I’m sooo in trouble when we get home, aren’t I?”
Wilson pressed his lips together before speaking. “Just…shut up for a while.”
House nodded. He could probably do that. For a while.
*******
House retreated to his office for the lunch break, because he could stand only so much group activity. Plus, that’s where he’d stashed the two chocolate-chunk brownies Wilson had picked up that morning. One might have been intended for Wilson, but he wasn’t sure.
As if on cue, the man appeared in the hallway and House mentally cursed as he stalked in. “Oh,” Wilson said, in that way of his. “That’s where my brownie went.”
“How long did it take to piece that puzzle together?”
Wilson said nothing, making a beeline for the second brownie perched on the desk. House almost felt bad as he grabbed it and took a huge bite.
“You never stood a chance,” he proclaimed, through a mouthful of deliciousness.
Wilson stared, seemingly in disbelief-though House couldn’t imagine why. After a moment, Wilson flopped into the chair in front of the desk.
“Well,” he said in defeat. “I guess I deserved that, for buying them.”
House just chewed and waited, while Wilson chewed on his lip and waited.
The standoff didn’t last long. “Do you,” Wilson began, hesitantly, “really think I pretend to care?”
House shook his head. “No. I told you, I didn’t say that.”
Wilson raised an eyebrow, so House continued. “I do think some of your staff are phoning it in. I’ve seen Brown do the hand-on-shoulder thing. He looks like he’s handling hazardous waste. Kinda creepy.”
Wilson nodded. “Yes, well, I know you don’t like to creep patients out.”
House returned the nod.
Wilson leaned forward and put his elbows on his knees. “I don’t set parameters so I can-so we can-look like we care. Having some guidelines protects everyone. It helps keep us from getting too drawn into the moment, and…”
He gestured vaguely.
“I know,” House said, putting his feet up on the desk. “I’ve seen what happens when you get too emotionally involved with a patient.”
Wilson worked his jaw for a moment. “It’s not just that, House.” He sighed. “You can so easily get attached, and then…Sometimes it’s better to detach a little and fall back on ‘sit by the bed, put a hand on his hand.’ I know you look down on that, but-”
“No, I don’t,” House corrected.
Wilson blinked. “You don’t…OK. Then why did you call me out down there?”
“I didn’t. I was calling her out.” At Wilson’s confused expression, he shrugged. “You already do this stuff, without trying to commodify it. And generally speaking, I have a problem with anyone who cherry-picks scientific evidence and tries to make a quick buck.”
House leaned back and looked at the ceiling for his next admission. “I don’t look down on what you do.”
After a beat, he glanced at Wilson, who appeared to be digesting that information. House took the opportunity to polish off the brownie.
“Fair enough,” Wilson replied. “But I have my own problem.”
“There’s no way you have just one,” House objected, spewing brownie crumbs.
Wilson held up his hands. “Well, this is the most pressing one right now. I’m wondering what a doctor gains from pretending to not care.”
Oh, gawd. Of course.
“I do not pretend,” House argued in a high-pitched whine.
Wilson wagged an index finger. “First of all, that sounds nothing like me. Secondly, you totally pretend. I mean, sometimes you do. I’ve caught you caring when you think no one’s looking.”
House rolled his eyes. “I dunno. I guess I need to protect myself,” he said with a pout. “My real problem is, I just feel so much.”
Wilson regarded him with an odd little smile that made House want to punch him.
He swung his legs off the desk. “My neural pain centers can only handle so much stimulation,” he continued as he limped to hover over Wilson. “I can’t take on other people’s pain, too. Don’t you see?”
Wilson just kept looking at him, until House started to grow agitated.
“I see,” Wilson finally affirmed.
“At last, someone sees me,” House sneered.
The odd smile returned and House gripped his cane, mentally willing Wilson to cease and desist before he was forced to stimulate the bastard’s neural pain centers.
Luckily, Wilson seemed to sense the threat. “C’mon,” he said, pushing to his feet. “We better get back.”
House gaped at him. “You think I’m going back? This place does have doors leading outside, you know.”
Wilson shrugged. “But the fun part is still ahead. Imagine all the opportunities for ridicule when we do the actual training.”
House paused to consider that, and Wilson leaned in, “You know there’s gonna be role-playing, right?”
House’s eyebrows shot up. “You think Cuddy will play the naughty nurse?”
Wilson did his head-tilt thing. “I somehow doubt it.”
House nodded in disappointment, but quickly brightened at his next thought. “Will you?”
Wilson smiled again, but this one was more…coy? “You never know.”
House studied him. “You think this training is as bogus as I do, don’t you?”
Wilson bit his lip. “I think you’re right about Schwartz. But I also think…I think what she’s doing still has merit.”
“Wow,” House deadpanned. “That’s so decisive.”
“Human interaction is messy, I hear.”
“That’s probably why I limit my time with the humans,” House remarked as they began to amble out of his office.
“Except me,” Wilson murmured, keeping his head down.
For once, House had no argument.
“Except you.”
-End