House fic: Obstacles
Obstacles
Summary: Wilson faces House’s vulnerability. House does his best to ignore it. Written for sick_house (prompt included at the end - I’ll update the tag in a few days) and cross-posted to housefic and my journal. Many thanks to asynca for merciless betaing and geekygecko and pwcorgigirl for kind and highly valuable concrit.
Rating: A weakling R for grown men discussing kinks behind closed doors, swearing and general medical nastiness.
Pairing: H/W friendship
Word count: ~4300
Spoilers: Starts two weeks after Top Secret and mentions events from Top Secret, Half-Wit and The Jerk (and Resignation but you have to squint for that one).
Disclaimer: I own this crappy computer. And a cricket bat.
Disclaimer the Second: I’ve decided that as long as the show fluffs the medicine all the time, I won’t take it too seriously either. I’m skipping a few non-essential details. This is a work of fiction. On with the torture…
During their long friendship, Wilson had learned that visits from House came in many shapes and forms. Nonetheless, he could honestly say that this was something entirely new.
Never before had House sidled in sideways - after a polite knock that Wilson was still recovering from - to sit at the edge of a chair and…do nothing? House would fidget and squirm, he would pace and bellow and fiddle with every tsotchke in sight - but he would never simply sit, his eyes glued to the carpet.
Wilson leaned forward, his chair creaking. It set off a definite twitch in the man-turned-statue across the desk. The sight was morbidly fascinating, but also deeply disturbing. Long minutes passed as Wilson waited for House to break the bizarre silence.
“Yesterday, I was…” House stuttered to a halt as Wilson finally caught his eyes. It wasn’t Sheepish House or Slightly Embarrassed House or even Somewhat Ashamed House sitting before him. He could see fear. Wilson knew the Housian rules of engagement: Don’t show doubt, don’t show weakness and never, ever show fear. And yet, there it was, in the stiffness of his shoulders, in the almost imperceptible tremor of his hands and deep in his eyes.
“What’s going on?” he asked with the beginnings of glacial dread in his stomach.
“It was pink,” House blurted out.
As three-word statements went, that was thoroughly unenlightening. For a moment, Wilson considered the possibility that he was alone and the man before him was a dream (no, he’d had his morning, noon and afternoon cups of coffee), a hallucination (no, House hadn’t been near said coffee) or psychosis secondary to brain tumor (despite Alanis Morisette’s claims, life was not that ironic).
Wilson was honestly lost. “Pink? What was? New pair of fluffy bunny slippers?”
The only response was a frown.
“What? Have you been in Cuddy’s underwear drawer again? You know I don’t care if you’ve started cross-dressing, but -” His mocking finally jolted House into action.
“I shot pink. There was blood in my semen, all right!” The last few words came out in an impressive falsetto.
Whatever Wilson had expected, it wasn’t that. He felt his jaw flap rather uselessly for a few seconds. The glacier thawed a little. “It does happen. Have you been, eh, very active lately?”
“No. It was bloody.” House rubbed his brow. The words were a quiet statement of something Wilson couldn’t quite catch.
“House, hematospermia is usually idiopathic. You know that.”
“Usually. How reassuring. Leg pain is usually muscular.”
Wilson had no reply for that. “We should probably -”
“Don’t say it,” House interrupted with a slightly anxious look on his face.
“You’ve had a prostate exam before -” hang on, this was House, the master of missed physicals, “- you have had a prostate exam before, right?”
“Of course. I’m not an idiot.”
Wilson considered the relative merits of the statement for a moment.
“Really, I’m not.” Again the quiet, not-quite-there hint of something.
“We could -” Wilson began before it finally clicked. Pink sperm - as frightening as that was for any man - would not send his friend to sit frozen like a deer in headlights in his office. “What is it?”
“I have trouble peeing.”
“Yes, I know. The catheter and all that.”
“No, I mean since then… and this morning there was blood in my urine.”
The glacier returned to his stomach in full force along with a particularly unpleasant list of words looping like a seven foot, bright green neon ticker in Wilson’s mind: Tumor - prostate or elsewhere, infection, benign hyperplasia, trauma. His heart jumped a little every time tumor went by. He suspected House was entertaining his own looping list.
“Has it happened before? The hematuria I mean.” He mentally crossed his fingers for a no. As long as the answer was no, there was nothing to worry about. Well, less to worry about.
House looked away. “A couple of times. There’s pain too; not all the time but it’s not just when I pee. It doesn’t help that I’ve been running for the bathroom every five minutes today.”
Oh, damn. Wilson studied his desk blotter for an answer. There was a simple one - and it wasn’t outside the realm of possibility. “Any fever? Urethral discharge? Any suspicion…I mean, is there any reason to do an STD panel?”
House’s response was a vehement repeat. “I am not an idiot.”
“Really? It’s half past seven and you’ve been walking around like this all day. Why? House, you’re a nephrologist. You know this could be…this could be serious.” His voice was steady, but he was struggling for calm.
“Gee, you think?!” House’s eyebrows were all but trying to fuse with his hairline.
“Yes, I think,” he shot back. “We should start with a rectal exam and urinalysis.” He paused for a moment as an ominous thought occurred to him. “There have been cases of hematospermia secondary to liver failure.”
House studied the carpet for a moment. “I don’t have any strange bruises. My liver is fine.”
“There’s also the risk of testicular carcino -”
“I know,” House interrupted and Wilson silently thanked him for it. He’d rather not think of examining his friend's testicles. The idea of doing a rectal exam was bad enough.
“Would you rather have someone else? Baker from urology is very good.”
“I came to you, didn’t I?”
“You did.” There was no way out of it. He felt his professional mask slip into place. It was immeasurably strange and uncomfortable to play doctor to House’s patient outside their repeated games of prescription tug-of-war.
“We should probably get a CBC, PSA and a full set of cultures to be on the safe side, but we’ll have a better idea of what we're dealing with after the exam.”
“Christ, Wilson. Would you stop sounding like an oncologist?”
Wilson’s stomach clenched at the words. He knew, of course, the chain reaction that could come next. Diagnosis, prognosis, treatment…remission, relapse appeared on his mental neon ticker. He knew every distancing trick and every professional distraction but still couldn’t keep his hands from shaking a little as he stood to put on his lab coat - or perhaps his suit of armor. “Let’s just go down to the clinic and get started on the tests. Could you stop by a bathroom and squeeze out a urine sample on the way?”
“Sure.” Quiet House was back; Wilson realized he much preferred Sheepish House or Angry House or any other House.
“I’ll go get everything ready then.”
“Can we do this quietly?”
“You mean under the radar?”
House gave a small nod.
“Of course.”
As they left, he stopped his hand a millisecond before it settled comfortingly on House’s shoulder. If House noticed, he didn’t show it.
###
Getting into exam room one undetected turned out to be easy. It certainly helped that it was well after six, the clinic was closed and Brenda Previn had relinquished her dominion for the night. Wilson had set about drowning his sense of dread in the mindless task of preparing the room (vacutainers, blood draw kit, ultrasound set up for rectal exam…) and starting a chart complete with a fake name and personal details as decoy. When House had slipped in the door - at least not sidling this time - he was carrying a (mercifully yellow-tinted) specimen cup and a nervous expression that couldn’t be hidden despite obvious attempts. Wilson had felt his pulse speed up: It was time to face the music.
Now, a set of vitals later, House sat perched on the edge of the exam table while Wilson opened the blood draw kit and prepared the median cubital vein.
“Did I ever ask if you have family in Transylvania?” Why had he never realized just how annoying a nervous House could be?
“Not yet. Was it my fair complexion that tipped you off?”
“You do have that eternal youth thing going…and I have the right to know if my precious bodily fluid is safe with you.”
Wilson glanced up at him. “Well, your jugular is looking very appealing from this angle.” The scar was barely noticeable anymore. He angled the needle and aimed.
“Cameron kissed me.”
The needled missed its mark completely.
“Fuck! You fucking stabbed me.”
“Sorry, I’m…what?” Wilson blinked a few times as his mind tried to catch up.
“You jabbed me. Goddamit, that hurts,” House loudly complained as he scrambled for a gauze pad.
“Sorry, I was distracted. Cameron kissed you? Cameron kissed you?” He wasn't entirely sure what shocked him the most.
House pointedly ignored him while cleaning the miniscule pinprick. “…yes, she kissed me.”
“And of course you thought this was the perfect moment to tell me." Trust House to spring something like that at the least suitable moment. "I thought she was over her crush.”
“I’m fairly sure she is. She was trying to distract me enough to get a blood sample.” The stained gauze was lobbed into a biohazard container.
“Why? When?”
House merely gave him a pointed look.
“Oh.”
When they all thought he was dying. Again. Funny how that kept happening. Wilson suspected that they'd all been rattled by it - and by discovering the truth. His curiosity won over his desire to forget those few days. “Did you kiss her back?”
House gave him a look that clearly said well, duh! "What would you do if a pretty girl half your age threw herself at you?”
“She’s not half your age. She's a grown woman and you can't just play with her emot -”
“I'm not playing with her," House interrupted. "She wants to kiss me? Fine. I’m not a project for her to lovingly restore to former glory. She knows that.” His voice had gone flat, his demeanor cold.
Wilson had almost forgotten what he was doing. He looked down and noticed he was still clutching the needle. “Let me just get a new kit. Did Cameron really think she could distract you enough to get a blood sample?”
“I think she planned on just jabbing me.”
“That’s…spectacularly dim.” He cleaned the skin again and picked up a fresh needle holder.
“Yes, as we’ve just seen. Could you at least try to hit the vein this time?”
“Watch it. I’m the one holding the needle.” He brandished it for effect. House glared back at him. “How could I forget? I have a throbbing, mangled arm to remind me.”
This time the needle slid in without detours. The vacutainers were labeled and order slips filled out when Wilson turned around, fresh gloves on and lubricant in hand, to find House watching him cautiously.
“I am not looking forward to the next part.”
Wilson couldn't blame him. “Don’t be a baby. You’re much too big and much too scruffy." He settled himself on a low stool and patted the exam table. "Come on, you know what to do.”
House still looked warily between Wilson and the table but finally unfastened his belt, dropping his pants to mid-thigh, and bent over the table. He looked literally uptight.
“Just relax and take it like a man.” House ignored the feeble attempt at humor. Wilson placed the pad of his index finger lightly against the anus with a pronounced feeling of point of no return. At least House had unclenched enough that he could slip all the way inside. He slid his finger around the curve of the rectum.
“Ow!” House jerked as Wilson put pressure on his prostate.
“Did that hurt?”
“No, I’m enjoying this immensely.” The answer came through clenched teeth. “Of course it hurts.”
“Sorry about that." He felt up along the central groove and followed the left edge of the gland down. The lobe was warm, but felt normal, mobile. No nodules, no indurations, no rigidity; nothing to warrant his apprehension…except, of course, for the idea of having a finger planted in the rectum of a close friend. Better not think of that. This was a normal examination. So what would he do now? He'd be reassuring; he'd chat. Right. "The pain? Is it just your prostate?"
"No." House shifted as if trying to pull away. "It's shooting all the way to my nuts."
Wilson cringed in sympathy. He moved on to the right lobe. House jerked again.
“Sorry, I'm trying to be gentle.” He swiped his finger across it, testing the texture. “Your prostate is warm… and the right lobe is swollen but the median furrow is intact. It's shifty -”
“Are you calling my prostate untrustworthy?”
“It's hardly the picture of health, is it? No, I meant it feels a little shifty, boggy. I can't feel any nodules though." He released an inward sigh of relief. "I think you have an infection.”
House considered it for a moment before answering, “No fever. No chills. No muscle aches.”
And House was supposed to be the smart one? “You take what? Six - seven thousand milligrams of acetaminophen every day? Of course you don’t have a fever.”
The mention of Vicodin caused a noticeable tightening of House’s shoulders - and an equally noticeable tightening around Wilson's finger. Well, at least the muscle tone was good. Wilson began easing his finger out. “It could be benign hyperplasia. You’re the right age for -”
“For my prostate to start ballooning? Gee, why didn't I think of that?" House asked with mock earnestness. "Oh, I know: The onset is too sudden and it hurts too much.”
“Infection is more likely,” Wilson conceded. He gave his gloved finger a quick look - no blood, good - before tossing a box of tissues on the exam table. “I’m done. You can wipe yourself off.”
House turned around, scowling and clutching his pants in one hand, the other busy wiping off the lubricant. "Do you mind? I prefer to wipe my ass in private."
Oh. The chart was suddenly very appealing. When he looked up, House was leaning slightly on the table. He grabbed a clean pair of gloves. "Ready?"
House merely looked pained and lifted his t-shirt.
Moving House's penis out of the way, Wilson slid his hand left hand behind the scrotum - and House jumped.
“Jesus! Your hands are cold.”
“Sorry," Wilson said for what felt like the fiftieth time. He quickly warmed his hands and resumed the palpation, thumb and forefinger sliding across and slightly squeezing the testes. House slowly moved further and further back on the table until he was fully sitting on it.
"Would you stop that?" Wilson grabbed a handful of shirt and yanked - with little effect. He looked up. "You know we have to do this."
House scratched a finger across his eyebrow; his foot had started bouncing. He moved back to the edge of the table. Wilson pushed the t-shirt out of the way again.
“I don't know what you're so worried about. I’ve done this before." Well, not this, exactly. "You'll need a transrectal ultrasound to rule out complications from the infection or -”
“Or to rule out a tumor. That's what it's about, isn't it? I’m the right age for that too,” House said quietly. “It’s an infection.”
Wilson shook his head. “Probably, but I’d feel better -”
“It’s an infection. Warm, tender prostate and trouble with the plumbing. It’s text book.”
“I read that book too. You know it’s indicated, particularly with a gland as soft as yours." He glanced up. House’s eye were fixed somewhere in the middle distance. While counting nose hairs was easy from his perspective, reading expressions was not. House looked almost apprehensive but as Wilson studied him, determination seeped into the fine web of lines around his eyes.
“I could always claim you had me by the balls.”
“Well, it has the benefit of being true." He quickly looked over the penis in front of him. Circumcised. Odd. He'd always assumed the opposite. "Okay, no lesions, no signs of an STD…and your testes are fine.”
“Thanks. My manhood appreciates the validation.”
He was moving his finger to trace the spermatic cord when House slid sideways off the table.
"Hell, no. That's enough. You do not get to check for hernias"
"Come on -"
"No!" House looked ridiculous leaning left against the table with one hand grasping his pants and the other pulling down his t-shirt to cover himself. He bore a striking resemblance to a petulant six-year-old: A half-dressed six-year-old in a Mexican standoff.
"Okay, let's make a deal: I won't check you for hernias, you agree to the ultrasound?"
House mulled it over. "Okay."
“Jump on the table so we can -”
“We? You’re not the one who’s about to have a transducer rod stuck up his ass.” The portable ultrasound gave a short ping when it was turned on.
“True, I’m the one who’s about to stick it up your ass.” He made a show out of spreading gel on the transducer rod.
“…Give me a hand will you.” House dropped his pants the rest of the way with the general air of a man about to face the firing squad. After a brief battle with shoes, pants and underwear, he wriggled into position on the exam table.
“How anyone can expect to derive pleasure from this is beyond me,” he all but whined as the transducer rod slowly slipped in.
“Don't knock it. Some people take advantage of having a prostate.”
“While it lasts.” The quiet reply was a sharp reminder of what they were doing.
“You said it yourself: It’s probably an infection.”
“Or I could have an appointment with a scalpel coming up soon,” House said evenly, either not caring or not knowing how the words made Wilson’s stomach clench.
The transducer was at the right position. Wilson studied the screen closely. The relief was both sudden and welcome. “Well, will you look at that…”
“What? Turn the screen. I want to see.” House attempted to turn over, shifting the transducer in the process. "Oh. Ow."
"Hey, lie still." He moved the screen and found the spot again. “Congratulations, House. You’re the father of a fine-looking prostatic abscess. It's definitely an infection.”
Whatever House was saying was muffled by the bunched up paper covering he had buried his face in. It was probably good, Wilson thought, when he heard a pattern of syllables distinctive of House’s more vile tempers. He withdrew the transducer and lobbed the box of tissues at House yet again. It bounced off his back. "Clean up. The urine culture should come back positive, but until then we’ll put you on ofloxacin and clindamycin. You’ll need to get checked again in a week to see if it’s working.”
The communion with the paper covering continued with a hrmf.
“If not, you have an appointment with a needle.”
House surfaced. “Better than a 10 blade.”
“Yep." Wilson turned the ultrasound off. A sneaking suspicion reared its head. "You know, I was wondering…”
“What?” House looked at him with suspicion.
“How exactly did that catheter come out? Any bleeding?”
He received a resounding scowl. "A little."
“So you self-catheterized, gave yourself an infection and gave it a nice place to fester by nicking your prostate. You’re an idiot."
"You better not tell anyone about this.” The menacing glare on House’s face was somewhat ruined by the briefs and pants around his ankles. He hurriedly pulled them up.
“Or what?” In retrospect, that was a truly dumb thing to say.
“Or I’ll start a rumor that you used to beg Julie to finger you,” House threw out. He was busy fighting his belt.
Wilson's stomach dropped to somewhere between his knees. He quickly lost his battle against the flush creeping all the way to the tips of his ears.
“…she did! She used to - hah!” The look of delighted realization was replaced by a predatory grin spreading across House's face.
“Please don’t…” He held up a hand as though that could stop House on the scent of blackmail material.
“What? You brought it up. Some people take advantage of having a prostate. Afraid I’ll ruin your manly reputation?”
“It was only…" Oh hell, explaining was a lost cause. "I’m not the one shooting pink.”
“Are you making fun of my fragile health? I could be dying here.” House put on his best I’m offended, I truly am, you wound me face. Wilson had spent years building immunity to it, but somehow it didn’t work this time.
“How very you. Turning this into a joke,” he said and noted the tiniest hint of honest pleading in his voice.
House’s sharp ears didn't miss it. “I’m not,” he said quietly. A sigh. “You’re good at this. Thanks.”
“You’re welcome,” Wilson replied, mostly surprised.
Later, as he sat in his car waiting for House to pick up his prescription, he wondered if he would ever get used to these little confrontations with House’s mortality.
###
Four weeks later
Wilson opened the file for his final review. Peter Uttoxeter, 47yo, Caucasian, kindergarten teacher and dollhouse enthusiast. Presented with perineal and scrotal pain, dysuria, oligouria, hematuria and hematospermia. And mild panic, Wilson mentally added with a smirk to match. House would kill him if he ever saw the file.
Vitals, CBC, digital rectal examination…Transrectal ultrasonography revealed 1.5 cm prostatic abscess... Urinalysis abnormal 9 WBC/hpf, 8 RBC/hpf, 1+ protein, 1+ leukocyte esterase, +bacteria, bilirubin and uribilinogen in normal range -
Well, it was nice to know House wasn’t lying about his liver.
…Blood culture negative, urine culture: E.coli >100.000 CFU…Diagnosis of acute bacterial prostatitis with abscess formation. Probable cause is infection following direct trauma during self-catheterization. Fever likely suppressed by patient’s daily use of acetaminophen.
Too much acetaminophen but that wasn’t going to change. A familiar weariness settled over him.
Treatment: 30 days, ofloxacin 400 mg PO bid, 300 mg clindamycin PO q8h…Second examination after 12 days -
All of five days too late and after Wilson had dragged him to an exam room under threat of telling Cuddy and/or Cameron.
- showed abscess still present. Transrectal aspiration was effective…
For draining the abscess, if not for preserving Wilson’s sanity.
…prostate appeared firm and non-tender by rectal exam after 30 d treatm-
He jumped as the balcony door banged open. House sauntered in, thankfully too far into his own mystery of the day to notice the open file on the desk.
“What is the differential for head pain, rage, liver failure, hypogonadism, bloody urine and a personality like a short-tempered Tasmanian devil?”
“…You?”
“You’ve fondled my gonads,” House grumbled before dropping himself on the couch to sulk. From the look of things, he planned to stay. Wilson casually closed the file.
“What do you have there?” House was peering at the file around a plastic statue he’d grabbed of the side table and was now fondling curiously. It was the elephant-headed Lord Ganesha given to Wilson by an Indian pest controller from Trenton with esophageal adenocarcinoma. Sanjeev Krishnaswarmi, his memory informed him. Died of post-operative complications.
“What’s going on with your patient?” Wilson deflected and rescued a random journal from among the clutter on his desk.
"Chase is threatening to smother him with a pillow.”
Well, that was more interesting than Journal on Thoracic Oncology. “I thought he was the calm one.”
“Don’t be fooled by the cuddly looks. Anyway, Foreman’s explanation is that he’s a teenager.” House had turned his attention to dismantling a tower of Duplo blocks built by the daughter of Wilson’s 9:30 breast cancer. Mindy. Stage IV infiltrating ductal carcinoma with lung metastasis.
“I’m…confused,” Wilson confessed. “Foreman said Chase is a teenager?”
“Nooo,” House drew out the word, ”that the kid with the small nuts is a teenager. Chase is all grown up. He’s having sex all over the hospital and everything.”
The Duplo tower had been converted into an odd-looking platform with a column in each corner.
“Speaking of Foreman…”
“Oh, shut up.” House shot him a decidedly annoyed look that quickly turned curious. “And you didn’t answer. What’s in the file? Another baldie-to-be?”
“Oh, this? Suspected prostate cancer.” Wilson mentally patted himself on the back for keeping the squeak out of his voice. Miraculously, House didn’t look suspicious.
“Sucks. Dying?”
“Aren’t we all?”
“That’s very profound of you.” He carefully placed Ganesha on the centre of the platform making it look - rather appropriately, in Wilson’s opinion - like a demented Taj Mahal. Mr. Krishnaswarmi’s words came back to him: Lord Ganesha is Vighneshvara, the creator and destroyer of obstacles. He is Ganapathi, the Lord of intellect and wisdom. Like the elephant, he can be powerful and destructive, yet he is loyal and benevolent. He sifts truth from untruth and his judgment is fair.
In the late morning light, House’s bizarre tribute to Mughal architecture cast a vaguely elephant-shaped shadow on the far wall. Wilson studied it for long moments, before turning back to his friend.
“No, he’ll live a long, long time,” he stated with certainty he knew was false.
House eyes scrutinized him. Wilson was seconds from squirming when he was saved from the intense stare by a knock. Cameron’s head peeked around the edge of the door. “Is he here?”
Wilson pointed to House who had taken to examining the statue’s hollow inside.
Cameron forged ahead. “We have the results for Nate’s chem panel and urinalysis. We need you in the office.”
House heaved a sigh worthy of a long-suffering saint before leveling himself to his feet. “See what I have to put up with?”
“Yes, you are an inspiration to us all,” he answered without any trace of sincerity as House haphazardly dropped the elephant statue on the desk. “Lunch?”
“I’ll find you," Wilson answered.
He watched as House ambled out the door. He looked like himself. He was Fearless House - even if it was only deception, it was convincing. He peered at the file on his desk that now had the Lord Ganesha parked squarely on top of it. Did House even think of it? Or had he moved on as soon as he had swallowed the last dose of antibiotic?
He slipped the file from under the figure and bent to lock it in the bottom drawer. Through the wall, he could hear another ddx in progress.
###
Prompt: 65. Prostatitis.
Summary: Wilson faces House’s vulnerability. House does his best to ignore it. Written for sick_house (prompt included at the end - I’ll update the tag in a few days) and cross-posted to housefic and my journal. Many thanks to asynca for merciless betaing and geekygecko and pwcorgigirl for kind and highly valuable concrit.
Rating: A weakling R for grown men discussing kinks behind closed doors, swearing and general medical nastiness.
Pairing: H/W friendship
Word count: ~4300
Spoilers: Starts two weeks after Top Secret and mentions events from Top Secret, Half-Wit and The Jerk (and Resignation but you have to squint for that one).
Disclaimer: I own this crappy computer. And a cricket bat.
Disclaimer the Second: I’ve decided that as long as the show fluffs the medicine all the time, I won’t take it too seriously either. I’m skipping a few non-essential details. This is a work of fiction. On with the torture…
During their long friendship, Wilson had learned that visits from House came in many shapes and forms. Nonetheless, he could honestly say that this was something entirely new.
Never before had House sidled in sideways - after a polite knock that Wilson was still recovering from - to sit at the edge of a chair and…do nothing? House would fidget and squirm, he would pace and bellow and fiddle with every tsotchke in sight - but he would never simply sit, his eyes glued to the carpet.
Wilson leaned forward, his chair creaking. It set off a definite twitch in the man-turned-statue across the desk. The sight was morbidly fascinating, but also deeply disturbing. Long minutes passed as Wilson waited for House to break the bizarre silence.
“Yesterday, I was…” House stuttered to a halt as Wilson finally caught his eyes. It wasn’t Sheepish House or Slightly Embarrassed House or even Somewhat Ashamed House sitting before him. He could see fear. Wilson knew the Housian rules of engagement: Don’t show doubt, don’t show weakness and never, ever show fear. And yet, there it was, in the stiffness of his shoulders, in the almost imperceptible tremor of his hands and deep in his eyes.
“What’s going on?” he asked with the beginnings of glacial dread in his stomach.
“It was pink,” House blurted out.
As three-word statements went, that was thoroughly unenlightening. For a moment, Wilson considered the possibility that he was alone and the man before him was a dream (no, he’d had his morning, noon and afternoon cups of coffee), a hallucination (no, House hadn’t been near said coffee) or psychosis secondary to brain tumor (despite Alanis Morisette’s claims, life was not that ironic).
Wilson was honestly lost. “Pink? What was? New pair of fluffy bunny slippers?”
The only response was a frown.
“What? Have you been in Cuddy’s underwear drawer again? You know I don’t care if you’ve started cross-dressing, but -” His mocking finally jolted House into action.
“I shot pink. There was blood in my semen, all right!” The last few words came out in an impressive falsetto.
Whatever Wilson had expected, it wasn’t that. He felt his jaw flap rather uselessly for a few seconds. The glacier thawed a little. “It does happen. Have you been, eh, very active lately?”
“No. It was bloody.” House rubbed his brow. The words were a quiet statement of something Wilson couldn’t quite catch.
“House, hematospermia is usually idiopathic. You know that.”
“Usually. How reassuring. Leg pain is usually muscular.”
Wilson had no reply for that. “We should probably -”
“Don’t say it,” House interrupted with a slightly anxious look on his face.
“You’ve had a prostate exam before -” hang on, this was House, the master of missed physicals, “- you have had a prostate exam before, right?”
“Of course. I’m not an idiot.”
Wilson considered the relative merits of the statement for a moment.
“Really, I’m not.” Again the quiet, not-quite-there hint of something.
“We could -” Wilson began before it finally clicked. Pink sperm - as frightening as that was for any man - would not send his friend to sit frozen like a deer in headlights in his office. “What is it?”
“I have trouble peeing.”
“Yes, I know. The catheter and all that.”
“No, I mean since then… and this morning there was blood in my urine.”
The glacier returned to his stomach in full force along with a particularly unpleasant list of words looping like a seven foot, bright green neon ticker in Wilson’s mind: Tumor - prostate or elsewhere, infection, benign hyperplasia, trauma. His heart jumped a little every time tumor went by. He suspected House was entertaining his own looping list.
“Has it happened before? The hematuria I mean.” He mentally crossed his fingers for a no. As long as the answer was no, there was nothing to worry about. Well, less to worry about.
House looked away. “A couple of times. There’s pain too; not all the time but it’s not just when I pee. It doesn’t help that I’ve been running for the bathroom every five minutes today.”
Oh, damn. Wilson studied his desk blotter for an answer. There was a simple one - and it wasn’t outside the realm of possibility. “Any fever? Urethral discharge? Any suspicion…I mean, is there any reason to do an STD panel?”
House’s response was a vehement repeat. “I am not an idiot.”
“Really? It’s half past seven and you’ve been walking around like this all day. Why? House, you’re a nephrologist. You know this could be…this could be serious.” His voice was steady, but he was struggling for calm.
“Gee, you think?!” House’s eyebrows were all but trying to fuse with his hairline.
“Yes, I think,” he shot back. “We should start with a rectal exam and urinalysis.” He paused for a moment as an ominous thought occurred to him. “There have been cases of hematospermia secondary to liver failure.”
House studied the carpet for a moment. “I don’t have any strange bruises. My liver is fine.”
“There’s also the risk of testicular carcino -”
“I know,” House interrupted and Wilson silently thanked him for it. He’d rather not think of examining his friend's testicles. The idea of doing a rectal exam was bad enough.
“Would you rather have someone else? Baker from urology is very good.”
“I came to you, didn’t I?”
“You did.” There was no way out of it. He felt his professional mask slip into place. It was immeasurably strange and uncomfortable to play doctor to House’s patient outside their repeated games of prescription tug-of-war.
“We should probably get a CBC, PSA and a full set of cultures to be on the safe side, but we’ll have a better idea of what we're dealing with after the exam.”
“Christ, Wilson. Would you stop sounding like an oncologist?”
Wilson’s stomach clenched at the words. He knew, of course, the chain reaction that could come next. Diagnosis, prognosis, treatment…remission, relapse appeared on his mental neon ticker. He knew every distancing trick and every professional distraction but still couldn’t keep his hands from shaking a little as he stood to put on his lab coat - or perhaps his suit of armor. “Let’s just go down to the clinic and get started on the tests. Could you stop by a bathroom and squeeze out a urine sample on the way?”
“Sure.” Quiet House was back; Wilson realized he much preferred Sheepish House or Angry House or any other House.
“I’ll go get everything ready then.”
“Can we do this quietly?”
“You mean under the radar?”
House gave a small nod.
“Of course.”
As they left, he stopped his hand a millisecond before it settled comfortingly on House’s shoulder. If House noticed, he didn’t show it.
###
Getting into exam room one undetected turned out to be easy. It certainly helped that it was well after six, the clinic was closed and Brenda Previn had relinquished her dominion for the night. Wilson had set about drowning his sense of dread in the mindless task of preparing the room (vacutainers, blood draw kit, ultrasound set up for rectal exam…) and starting a chart complete with a fake name and personal details as decoy. When House had slipped in the door - at least not sidling this time - he was carrying a (mercifully yellow-tinted) specimen cup and a nervous expression that couldn’t be hidden despite obvious attempts. Wilson had felt his pulse speed up: It was time to face the music.
Now, a set of vitals later, House sat perched on the edge of the exam table while Wilson opened the blood draw kit and prepared the median cubital vein.
“Did I ever ask if you have family in Transylvania?” Why had he never realized just how annoying a nervous House could be?
“Not yet. Was it my fair complexion that tipped you off?”
“You do have that eternal youth thing going…and I have the right to know if my precious bodily fluid is safe with you.”
Wilson glanced up at him. “Well, your jugular is looking very appealing from this angle.” The scar was barely noticeable anymore. He angled the needle and aimed.
“Cameron kissed me.”
The needled missed its mark completely.
“Fuck! You fucking stabbed me.”
“Sorry, I’m…what?” Wilson blinked a few times as his mind tried to catch up.
“You jabbed me. Goddamit, that hurts,” House loudly complained as he scrambled for a gauze pad.
“Sorry, I was distracted. Cameron kissed you? Cameron kissed you?” He wasn't entirely sure what shocked him the most.
House pointedly ignored him while cleaning the miniscule pinprick. “…yes, she kissed me.”
“And of course you thought this was the perfect moment to tell me." Trust House to spring something like that at the least suitable moment. "I thought she was over her crush.”
“I’m fairly sure she is. She was trying to distract me enough to get a blood sample.” The stained gauze was lobbed into a biohazard container.
“Why? When?”
House merely gave him a pointed look.
“Oh.”
When they all thought he was dying. Again. Funny how that kept happening. Wilson suspected that they'd all been rattled by it - and by discovering the truth. His curiosity won over his desire to forget those few days. “Did you kiss her back?”
House gave him a look that clearly said well, duh! "What would you do if a pretty girl half your age threw herself at you?”
“She’s not half your age. She's a grown woman and you can't just play with her emot -”
“I'm not playing with her," House interrupted. "She wants to kiss me? Fine. I’m not a project for her to lovingly restore to former glory. She knows that.” His voice had gone flat, his demeanor cold.
Wilson had almost forgotten what he was doing. He looked down and noticed he was still clutching the needle. “Let me just get a new kit. Did Cameron really think she could distract you enough to get a blood sample?”
“I think she planned on just jabbing me.”
“That’s…spectacularly dim.” He cleaned the skin again and picked up a fresh needle holder.
“Yes, as we’ve just seen. Could you at least try to hit the vein this time?”
“Watch it. I’m the one holding the needle.” He brandished it for effect. House glared back at him. “How could I forget? I have a throbbing, mangled arm to remind me.”
This time the needle slid in without detours. The vacutainers were labeled and order slips filled out when Wilson turned around, fresh gloves on and lubricant in hand, to find House watching him cautiously.
“I am not looking forward to the next part.”
Wilson couldn't blame him. “Don’t be a baby. You’re much too big and much too scruffy." He settled himself on a low stool and patted the exam table. "Come on, you know what to do.”
House still looked warily between Wilson and the table but finally unfastened his belt, dropping his pants to mid-thigh, and bent over the table. He looked literally uptight.
“Just relax and take it like a man.” House ignored the feeble attempt at humor. Wilson placed the pad of his index finger lightly against the anus with a pronounced feeling of point of no return. At least House had unclenched enough that he could slip all the way inside. He slid his finger around the curve of the rectum.
“Ow!” House jerked as Wilson put pressure on his prostate.
“Did that hurt?”
“No, I’m enjoying this immensely.” The answer came through clenched teeth. “Of course it hurts.”
“Sorry about that." He felt up along the central groove and followed the left edge of the gland down. The lobe was warm, but felt normal, mobile. No nodules, no indurations, no rigidity; nothing to warrant his apprehension…except, of course, for the idea of having a finger planted in the rectum of a close friend. Better not think of that. This was a normal examination. So what would he do now? He'd be reassuring; he'd chat. Right. "The pain? Is it just your prostate?"
"No." House shifted as if trying to pull away. "It's shooting all the way to my nuts."
Wilson cringed in sympathy. He moved on to the right lobe. House jerked again.
“Sorry, I'm trying to be gentle.” He swiped his finger across it, testing the texture. “Your prostate is warm… and the right lobe is swollen but the median furrow is intact. It's shifty -”
“Are you calling my prostate untrustworthy?”
“It's hardly the picture of health, is it? No, I meant it feels a little shifty, boggy. I can't feel any nodules though." He released an inward sigh of relief. "I think you have an infection.”
House considered it for a moment before answering, “No fever. No chills. No muscle aches.”
And House was supposed to be the smart one? “You take what? Six - seven thousand milligrams of acetaminophen every day? Of course you don’t have a fever.”
The mention of Vicodin caused a noticeable tightening of House’s shoulders - and an equally noticeable tightening around Wilson's finger. Well, at least the muscle tone was good. Wilson began easing his finger out. “It could be benign hyperplasia. You’re the right age for -”
“For my prostate to start ballooning? Gee, why didn't I think of that?" House asked with mock earnestness. "Oh, I know: The onset is too sudden and it hurts too much.”
“Infection is more likely,” Wilson conceded. He gave his gloved finger a quick look - no blood, good - before tossing a box of tissues on the exam table. “I’m done. You can wipe yourself off.”
House turned around, scowling and clutching his pants in one hand, the other busy wiping off the lubricant. "Do you mind? I prefer to wipe my ass in private."
Oh. The chart was suddenly very appealing. When he looked up, House was leaning slightly on the table. He grabbed a clean pair of gloves. "Ready?"
House merely looked pained and lifted his t-shirt.
Moving House's penis out of the way, Wilson slid his hand left hand behind the scrotum - and House jumped.
“Jesus! Your hands are cold.”
“Sorry," Wilson said for what felt like the fiftieth time. He quickly warmed his hands and resumed the palpation, thumb and forefinger sliding across and slightly squeezing the testes. House slowly moved further and further back on the table until he was fully sitting on it.
"Would you stop that?" Wilson grabbed a handful of shirt and yanked - with little effect. He looked up. "You know we have to do this."
House scratched a finger across his eyebrow; his foot had started bouncing. He moved back to the edge of the table. Wilson pushed the t-shirt out of the way again.
“I don't know what you're so worried about. I’ve done this before." Well, not this, exactly. "You'll need a transrectal ultrasound to rule out complications from the infection or -”
“Or to rule out a tumor. That's what it's about, isn't it? I’m the right age for that too,” House said quietly. “It’s an infection.”
Wilson shook his head. “Probably, but I’d feel better -”
“It’s an infection. Warm, tender prostate and trouble with the plumbing. It’s text book.”
“I read that book too. You know it’s indicated, particularly with a gland as soft as yours." He glanced up. House’s eye were fixed somewhere in the middle distance. While counting nose hairs was easy from his perspective, reading expressions was not. House looked almost apprehensive but as Wilson studied him, determination seeped into the fine web of lines around his eyes.
“I could always claim you had me by the balls.”
“Well, it has the benefit of being true." He quickly looked over the penis in front of him. Circumcised. Odd. He'd always assumed the opposite. "Okay, no lesions, no signs of an STD…and your testes are fine.”
“Thanks. My manhood appreciates the validation.”
He was moving his finger to trace the spermatic cord when House slid sideways off the table.
"Hell, no. That's enough. You do not get to check for hernias"
"Come on -"
"No!" House looked ridiculous leaning left against the table with one hand grasping his pants and the other pulling down his t-shirt to cover himself. He bore a striking resemblance to a petulant six-year-old: A half-dressed six-year-old in a Mexican standoff.
"Okay, let's make a deal: I won't check you for hernias, you agree to the ultrasound?"
House mulled it over. "Okay."
“Jump on the table so we can -”
“We? You’re not the one who’s about to have a transducer rod stuck up his ass.” The portable ultrasound gave a short ping when it was turned on.
“True, I’m the one who’s about to stick it up your ass.” He made a show out of spreading gel on the transducer rod.
“…Give me a hand will you.” House dropped his pants the rest of the way with the general air of a man about to face the firing squad. After a brief battle with shoes, pants and underwear, he wriggled into position on the exam table.
“How anyone can expect to derive pleasure from this is beyond me,” he all but whined as the transducer rod slowly slipped in.
“Don't knock it. Some people take advantage of having a prostate.”
“While it lasts.” The quiet reply was a sharp reminder of what they were doing.
“You said it yourself: It’s probably an infection.”
“Or I could have an appointment with a scalpel coming up soon,” House said evenly, either not caring or not knowing how the words made Wilson’s stomach clench.
The transducer was at the right position. Wilson studied the screen closely. The relief was both sudden and welcome. “Well, will you look at that…”
“What? Turn the screen. I want to see.” House attempted to turn over, shifting the transducer in the process. "Oh. Ow."
"Hey, lie still." He moved the screen and found the spot again. “Congratulations, House. You’re the father of a fine-looking prostatic abscess. It's definitely an infection.”
Whatever House was saying was muffled by the bunched up paper covering he had buried his face in. It was probably good, Wilson thought, when he heard a pattern of syllables distinctive of House’s more vile tempers. He withdrew the transducer and lobbed the box of tissues at House yet again. It bounced off his back. "Clean up. The urine culture should come back positive, but until then we’ll put you on ofloxacin and clindamycin. You’ll need to get checked again in a week to see if it’s working.”
The communion with the paper covering continued with a hrmf.
“If not, you have an appointment with a needle.”
House surfaced. “Better than a 10 blade.”
“Yep." Wilson turned the ultrasound off. A sneaking suspicion reared its head. "You know, I was wondering…”
“What?” House looked at him with suspicion.
“How exactly did that catheter come out? Any bleeding?”
He received a resounding scowl. "A little."
“So you self-catheterized, gave yourself an infection and gave it a nice place to fester by nicking your prostate. You’re an idiot."
"You better not tell anyone about this.” The menacing glare on House’s face was somewhat ruined by the briefs and pants around his ankles. He hurriedly pulled them up.
“Or what?” In retrospect, that was a truly dumb thing to say.
“Or I’ll start a rumor that you used to beg Julie to finger you,” House threw out. He was busy fighting his belt.
Wilson's stomach dropped to somewhere between his knees. He quickly lost his battle against the flush creeping all the way to the tips of his ears.
“…she did! She used to - hah!” The look of delighted realization was replaced by a predatory grin spreading across House's face.
“Please don’t…” He held up a hand as though that could stop House on the scent of blackmail material.
“What? You brought it up. Some people take advantage of having a prostate. Afraid I’ll ruin your manly reputation?”
“It was only…" Oh hell, explaining was a lost cause. "I’m not the one shooting pink.”
“Are you making fun of my fragile health? I could be dying here.” House put on his best I’m offended, I truly am, you wound me face. Wilson had spent years building immunity to it, but somehow it didn’t work this time.
“How very you. Turning this into a joke,” he said and noted the tiniest hint of honest pleading in his voice.
House’s sharp ears didn't miss it. “I’m not,” he said quietly. A sigh. “You’re good at this. Thanks.”
“You’re welcome,” Wilson replied, mostly surprised.
Later, as he sat in his car waiting for House to pick up his prescription, he wondered if he would ever get used to these little confrontations with House’s mortality.
###
Four weeks later
Wilson opened the file for his final review. Peter Uttoxeter, 47yo, Caucasian, kindergarten teacher and dollhouse enthusiast. Presented with perineal and scrotal pain, dysuria, oligouria, hematuria and hematospermia. And mild panic, Wilson mentally added with a smirk to match. House would kill him if he ever saw the file.
Vitals, CBC, digital rectal examination…Transrectal ultrasonography revealed 1.5 cm prostatic abscess... Urinalysis abnormal 9 WBC/hpf, 8 RBC/hpf, 1+ protein, 1+ leukocyte esterase, +bacteria, bilirubin and uribilinogen in normal range -
Well, it was nice to know House wasn’t lying about his liver.
…Blood culture negative, urine culture: E.coli >100.000 CFU…Diagnosis of acute bacterial prostatitis with abscess formation. Probable cause is infection following direct trauma during self-catheterization. Fever likely suppressed by patient’s daily use of acetaminophen.
Too much acetaminophen but that wasn’t going to change. A familiar weariness settled over him.
Treatment: 30 days, ofloxacin 400 mg PO bid, 300 mg clindamycin PO q8h…Second examination after 12 days -
All of five days too late and after Wilson had dragged him to an exam room under threat of telling Cuddy and/or Cameron.
- showed abscess still present. Transrectal aspiration was effective…
For draining the abscess, if not for preserving Wilson’s sanity.
…prostate appeared firm and non-tender by rectal exam after 30 d treatm-
He jumped as the balcony door banged open. House sauntered in, thankfully too far into his own mystery of the day to notice the open file on the desk.
“What is the differential for head pain, rage, liver failure, hypogonadism, bloody urine and a personality like a short-tempered Tasmanian devil?”
“…You?”
“You’ve fondled my gonads,” House grumbled before dropping himself on the couch to sulk. From the look of things, he planned to stay. Wilson casually closed the file.
“What do you have there?” House was peering at the file around a plastic statue he’d grabbed of the side table and was now fondling curiously. It was the elephant-headed Lord Ganesha given to Wilson by an Indian pest controller from Trenton with esophageal adenocarcinoma. Sanjeev Krishnaswarmi, his memory informed him. Died of post-operative complications.
“What’s going on with your patient?” Wilson deflected and rescued a random journal from among the clutter on his desk.
"Chase is threatening to smother him with a pillow.”
Well, that was more interesting than Journal on Thoracic Oncology. “I thought he was the calm one.”
“Don’t be fooled by the cuddly looks. Anyway, Foreman’s explanation is that he’s a teenager.” House had turned his attention to dismantling a tower of Duplo blocks built by the daughter of Wilson’s 9:30 breast cancer. Mindy. Stage IV infiltrating ductal carcinoma with lung metastasis.
“I’m…confused,” Wilson confessed. “Foreman said Chase is a teenager?”
“Nooo,” House drew out the word, ”that the kid with the small nuts is a teenager. Chase is all grown up. He’s having sex all over the hospital and everything.”
The Duplo tower had been converted into an odd-looking platform with a column in each corner.
“Speaking of Foreman…”
“Oh, shut up.” House shot him a decidedly annoyed look that quickly turned curious. “And you didn’t answer. What’s in the file? Another baldie-to-be?”
“Oh, this? Suspected prostate cancer.” Wilson mentally patted himself on the back for keeping the squeak out of his voice. Miraculously, House didn’t look suspicious.
“Sucks. Dying?”
“Aren’t we all?”
“That’s very profound of you.” He carefully placed Ganesha on the centre of the platform making it look - rather appropriately, in Wilson’s opinion - like a demented Taj Mahal. Mr. Krishnaswarmi’s words came back to him: Lord Ganesha is Vighneshvara, the creator and destroyer of obstacles. He is Ganapathi, the Lord of intellect and wisdom. Like the elephant, he can be powerful and destructive, yet he is loyal and benevolent. He sifts truth from untruth and his judgment is fair.
In the late morning light, House’s bizarre tribute to Mughal architecture cast a vaguely elephant-shaped shadow on the far wall. Wilson studied it for long moments, before turning back to his friend.
“No, he’ll live a long, long time,” he stated with certainty he knew was false.
House eyes scrutinized him. Wilson was seconds from squirming when he was saved from the intense stare by a knock. Cameron’s head peeked around the edge of the door. “Is he here?”
Wilson pointed to House who had taken to examining the statue’s hollow inside.
Cameron forged ahead. “We have the results for Nate’s chem panel and urinalysis. We need you in the office.”
House heaved a sigh worthy of a long-suffering saint before leveling himself to his feet. “See what I have to put up with?”
“Yes, you are an inspiration to us all,” he answered without any trace of sincerity as House haphazardly dropped the elephant statue on the desk. “Lunch?”
“I’ll find you," Wilson answered.
He watched as House ambled out the door. He looked like himself. He was Fearless House - even if it was only deception, it was convincing. He peered at the file on his desk that now had the Lord Ganesha parked squarely on top of it. Did House even think of it? Or had he moved on as soon as he had swallowed the last dose of antibiotic?
He slipped the file from under the figure and bent to lock it in the bottom drawer. Through the wall, he could hear another ddx in progress.
###
Prompt: 65. Prostatitis.