Inquiry: Day Nine, 11 a.m. - Dr. Lisa Cuddy 3
Title: InquiryAuthor: zeppomarx
Characters: All the usual suspects, plus more.
Summary: When a panel is convened to review the facts of Gregory House’s life, his fellows (past and present), colleagues, patients and friends are called to testify.
Thanks: To Brigid45, for her infinite wisdom and advice.
Warnings, etc.: Possible character death.
Disclaimers: Don't own House or any of the show's characters. If I did, things might have gone a little differently.
Chapter Summary: Testimony of Dr. Lisa Cuddy 3
Day Nine, 11 a.m.
During the break, Cuddy spent most of her time in the ladies’ room, touching up her makeup and doing a little yoga to try to relax herself. When she returned to the inquiry room, it seemed much cooler than before, thank goodness.
Fortunately for Cuddy, the panel chair, not the annoying woman with the difficult questions, resumed the questioning. “Dr. Cuddy, we’d like to spend a few minutes on what happened just before Dr. House was admitted to Mayfield Psychiatric Hospital. At what point did you become aware there was a problem?”
Okay… this seemed relatively safe. “He had said something quite unpleasant to me one evening as I was getting ready to leave. The next day, he behaved oddly all day, and then announced from the balcony overlooking the lobby that we had slept together. Well, I was furious. First, I tried to fire him, and then we had a confrontation in my office… suddenly, he sort of collapsed -- I don’t mean physically… I mean he deflated emotionally.”
That was one of the worst moments of her life, seeing House, always so sure of his mind, lose the one thing he valued most. When she’d finally realized something was seriously wrong and had looked closely at him, he was so distant… so devastated… that he almost didn’t look like himself. “Then he told me he had been suffering from hallucinations for awhile, and that he’d just realized he’d also had a delusion… in particular, a delusion about me. I took him in to Dr. Wilson, who then arranged for him to go to Mayfield.”
“Did you, or any of the other physicians on staff, check Dr. House out for possible physical causes for those hallucinations?”
“I understood from Dr. Wilson that Dr. House himself eliminated everything except Vicodin as a possible cause.”
At a nod from the chairman, the man at her far right got up and brought her a scrap of envelope. Unwillingly, she took it from him as the panel chair asked, “Is this Dr. House’s handwriting? Is this his self-diagnosis?”
She looked it over before handing it back to the panelist, who returned to his seat while she answered. “Yes, I believe it is.”
“These are the items Dr. House listed and crossed out as possible causes, correct?”
She nodded, not wanting to give the panel any more than was necessary, hoping to end this farce as quickly as possible.
“Did you notice anything missing from this list that might have contributed to his problems at the time?”
“Not that I’m aware of. Besides, House was one of the greatest diagnosticians in the world. I would have had no reason to second guess him.”
“Not even when he had readily admitted to mental impairment?”
“No… I... I guess not.” Wilson had shown her the list, and told her how House had systematically gone through it until only Vicodin remained.
“You have already told us that you often challenged Dr. House’s medical judgment about a patient, refusing some of the tests and treatments he proposed. Are you telling us that you felt it was all right to question his judgment about patient care, but not about his own health, where he probably could have used an objective viewpoint?”
“Yes, I suppose I am.” She had a bad feeling about this. Taking a deep, calming breath, she braced herself.
“We have looked over this list and compared it to Dr. House’s medical history, and we see one very big omission.”
“And what would that be?” Quickly losing the momentary calm the deep breath had given her, Cuddy was now finding it hard to either catch her breath or contain her irritation. She was getting very tired of having everything she’d ever done disputed by this panel, especially when she didn’t want to be here in the first place.
“Three years prior, Dr. House had experienced a severe brain injury as a result of a bus crash. Following that injury, which was barely treated at all, he pushed himself to the limits of his endurance, and then underwent a deep brain stimulation -- a very dangerous procedure conducted for no medical reason that we can determine. If his cracked skull, his insistence on continuing to work while injured or the DBS performed on him had long-lasting effects -- which they certainly might have -- they could quite easily have contributed to his mental confusion.”
“That… that never occurred to me.” Oh, God.
“Apparently, Dr. House also suffered a few subsequent head injuries before he went to Mayfield, which would have compounded the problem. Let’s see…” The panel chair looked through his notes. “Ah. Here it is. He was in a motorcycle accident, may have sustained some kind of injury when the SWAT team attempted to capture the gunman holding him and others hostage, not to mention a fall off his chair only the day before his psychotic break. And those are just the ones we know about.”
“I suppose traumatic brain injury might have contributed to the problem,” she admitted, shocked that she hadn’t considered the possibility at the time.
Throughout this session, the woman at the end of the table had, thank goodness, been silent. After adjusting her reading glasses and shuffling through some papers, she now spoke up. “Dr. Cuddy,” she began, and Cuddy’s heart sank, “you mentioned that Dr. House said he’d had a delusion, as well as having hallucinated for a few days. Is that correct?”
“Yes,” said Cuddy cautiously, not sure where this was going.
“I would hope that you know that hallucinations and delusions of the type Dr. House apparently experienced are not terribly rare in people who have had serious traumatic brain injuries such as the one Dr. House experienced. The mental impairment sometimes does not show itself until months or even years after the initial injury. In addition, the dangerous effects of brain trauma are compounded with each subsequent head injury.”
“I was aware of that,” said Cuddy, although she couldn’t honestly say she’d ever read anything specific about the hallucinations and delusions aspect of TBI.
“On the other hand, according to an FDA study of… let’s see…” She closely scanned down the paper in her hand. “Ah, here it is. According to an FDA study of 29,661 Vicodin users and abusers, literally zero percent of them suffered from delusions.” Nemesis Lady looked up over her reading glasses and stared Cuddy right in the eye until Cuddy became so disconcerted that she finally looked away.
Cuddy was flabbergasted. Zero percent? Zero percent?! How could that be?
“Did you know about this, Dr. Cuddy? Do you know if Dr. Wilson… or Dr. Nolan… were aware of this information?”
“N-no… no. I hadn’t realized that.” She needed to pull herself together, and fast. “I really don’t know if Drs. Wilson or Nolan knew that fact.”
“So you simply took Dr. House’s word for it that the Vicodin was causing his symptoms and never got another opinion from someone who might have provided an objective diagnosis for Dr. House’s symptoms?”
Damn, damn, damn, thought Cuddy, feeling almost physically ill. She couldn’t believe it had never dawned on her to suspect a physical cause other than the Vicodin. She and Wilson had been so sure his addiction had caused his symptoms… they’d been almost eager to believe House’s analysis of the situation, because they were already inclined to think that all of his problems were caused by Vicodin.
Her lack of objectivity -- and Wilson’s, because she wasn’t willing to let him off the hook on this -- had clearly led to a missed diagnosis for House’s delusion, and probably for his hallucinations as well. It was just what House had always accused her of: Leading with her feelings instead of her mind. Maybe she really was as bad a doctor as House had always suggested. Had their mistake about what caused House’s breakdown kept him from being treated appropriately? Had he continued to suffer mental impairment because of their neglect? What were the consequences on House’s health because of this huge error in judgment? Oh, God, she really didn’t want to go there.
“Dr. Cuddy?” Nemesis Lady’s voice cut through Cuddy’s mental fog. “Would you please answer the question?”
Cuddy closed her eyes for a moment, breathing deeply again to gather her strength before answering. “Yes. We took his word for it. And no, we did not get another opinion about the cause of Dr. House’s problem. Based on his self-diagnosis, we just assumed…” House’s voice, mocking people who assume things, echoed in her mind.
Grabbing the bottle of water in front of her, she aggressively twisted off the cap, and took a big swallow, hoping the water would not only cool her off, but that the act of taking a drink might give her enough time to prepare for the next question, which she earnestly hoped would not come from the woman to her left. For the first time since her testimony had started, Lisa Cuddy lucked out. The next question reverted to the chairman.
“Please tell us what happened after Dr. House was released from Mayfield.”
Having now calmed herself down somewhat, she answered evenly. “At first, he refused to come back to work. He said he didn’t think it would be good for his recovery.”
“And how did you react to that?”
“I accepted it, although, I guess, in the back of my mind, I was trying to find a way to convince him to return.”
“Because his talent was so valuable to the hospital?”
“Yes.” And because she’d missed the excitement of having him around. She’d wanted him back in her life.
“Then what happened?”
“Eventually, he decided to return, and I helped him get his medical license reinstated.” In fact, she’d bypassed the reinstatement rules just to get him back to treating patients sooner.
“And once he returned to his job? Then what?”
“Things went back to normal,” she said. Normal, except for the fact that she was now involved with Lucas… and had been determined to keep that information from House.
“What exactly did you do when Dr. House finally returned to work after his time at Mayfield?”
“Pretty much what I had always done,” she replied. “Gave him cases, tried to rein in his insanity, made sure he worked his clinic hours and filled out his paperwork.” Had she really just used the word insanity to describe someone who had just been released from a mental institution? Out of the corner of her eye, she saw the woman to her left react strongly to that word, but she’d said nothing, for which Cuddy was grateful.
“About that paperwork, Dr. Cuddy,” said the chairman, apparently taking the questioning in a new direction, one that Cuddy hoped would be less disturbing to her. “Could you please explain to us why Dr. House was not assigned an administrative assistant to handle his paperwork for him, when all the other department heads were?”
Not bad. This seemed like a fairly safe question. “His department was much smaller than the others,” she answered.
“But bringing in more money. Also, from what we’ve heard, because of his increasing fame, Dr. House received numerous requests for his services in the mail every week. Should the size of the department preclude his getting administrative help? And was it a good use of your time or his to deal with his paperwork?”
“I saw it as an essential part of both of our jobs. Besides, he didn’t want an assistant.”
“His desires shouldn’t have been part of the equation, should they, Dr. Cuddy? Especially if it would make his department function more smoothly. It sounds to me as if this might have been a way to micromanage Dr. House with busywork that could -- and should -- have been handled by an assistant. Busywork that distracted him from taking on more cases.”
“That’s not how I saw it. I felt he needed to be more disciplined.” Cuddy always felt secure talking about management issues. Her job at PPTH had been more important to her than anything, and she’d poured her entire being into her career and that hospital. Both of which had been damaged nearly as badly as her home had after House drove through the middle of her dining room.
She’d never been so humiliated in her life as when she started hearing from colleagues all over the country who had seen the story on the national news. Suddenly, she’d gone from being the high-powered dean of medicine at a world-class hospital to the victim of domestic violence… not a role she was comfortable with. No, she was the strong, capable, take-charge woman… not the victim. And yet, how else could she describe herself now? House had gone nuts (yet again) and had taken her down with him. How could he have done this to her?
After a pause to take a couple of notes, the panel chairman went on. “From what we can tell, Dr. House seems to have been remarkably disciplined when it came to performing the main function of his job, which was to diagnose lost causes.”
“He was almost a savant that way,” replied Cuddy, trying by sheer force to squeeze all those extraneous thoughts out of her mind. “I was just attempting to get him to be more responsible about the less flamboyant parts of his job.”
“Like the clinic?”
“Yes. Like the clinic.” Was that a dig? Cuddy wondered. The panel members clearly had issues with having House work in the clinic.
“Several of the witnesses have described Dr. House’s practical jokes, meddlesome nature, distractions, and apparent laziness on the job. However, numerous studies do show that when extraordinarily bright and creative people get bored, they often get into trouble. Is it possible that if Dr. House had been allowed to devote all of his brainpower to diagnosing patients, he might have been less troublesome to deal with?”
This got Cuddy’s attention. She’d never really considered the possibility that she might not have been working to House’s strengths, or managing him in the best way possible. She’d always been so damned sure of herself and her methods. However, if what this man said was true -- and they certainly seemed to have done their homework -- maybe… just maybe… another approach might have worked better, and might have kept House from being so difficult. “Actually,” she admitted. “I’m not sure. It seemed to be the right approach at the time.”
“Trying to get him to conform?”
“Yes. Trying to get him to conform.” But would House ever have been able to conform? Was her attempt to make him do so an exercise in futility for both of them?
The questioning got back on track at this point. “What workplace accommodations were made to support Dr. House in his recovery after he returned to PPTH following his stint at Mayfield?”
“There weren’t any, really. Initially, until his medical license was reinstated, he worked in the department on an advisory basis. Once he got his medical license again, things returned to normal, as I said.”
“So there was no psychological counseling to help him adjust?”
“As far as I know, he was continuing to see Dr. Nolan on a regular basis.”
“As far as you know?”
“Yes. I wasn’t really involved.”
“Dr. Nolan tells us that he tried repeatedly to reach you, but that you never returned his calls.”
“I didn’t see the need to. House was back at work and seemed to be doing okay.”
“Seemed to be? How much interaction did you actually have with him during this time, Dr. Cuddy?”
“I guess it was about the same as before.” No, it wasn’t, said that part of her mind she was trying so very hard not to listen to. You know perfectly well that you were avoiding him, hoping he didn’t find out you were fooling around with his friend Lucas.
“You seem to have been remarkably detached from the progress of a prized employee who had just suffered a serious mental breakdown.”
Okay. Tell the truth. That’s good. Be honest. “To be honest, I was involved with someone else at the time, and was trying to keep my distance from Dr. House.”
“Would this have been his friend, Lucas Douglas?”
“Yes.” Oh… they knew about Lucas already, did they?
“We understand you refrained from telling him or Dr. Wilson that you were in a relationship with Mr. Douglas. Is that right?”
“Yes. I didn’t tell Dr. Wilson, because I knew he’d tell House. And I felt that if House knew, he would try to break us up.”
“Because the two of you had seemed to be on a trajectory toward a relationship yourselves before his breakdown?”
“Something like that. He was obsessed with me. Sometimes, it was verging on stalker behavior.” Cuddy remembered all those dates when House would show up at a restaurant or on her doorstep, just to mess with her.
“Interesting. How did you react to this ‘stalker behavior’?”
The moment at her front door when House had, yet again, crashed one of her dates, this one with that Eastern Lube guy, popped into her head. “Do you like me?” she’d asked him. Without taking time to think about the ramifications of it, her answer popped out. “I asked him if he liked me,” she answered, realizing as she said it that if she’d really believed House was stalking her, this wasn’t a very productive way to get him to get him to stop. In fact, she’d purposely taunted him, because she’d been more flattered by his attention than annoyed, and had secretly wanted him to declare himself.
“That doesn’t sound as if you believed he was stalking you, Dr. Cuddy. In fact, it sounds as if you were encouraging his behavior.”
“No,” she said, once again on the spot. “I was trying to get him to admit that he was interfering with my private life.”
“Back to what happened after Dr. House left Mayfield… would you say you weren’t close enough to Dr. House at this time to take note of his progress after leaving Mayfield?”
“I wasn’t aware of any progress.”
Nemesis interjected. “That wasn’t the question, Dr. Cuddy. Were you paying attention to what was going on with him or not?”
Cuddy gritted her teeth. “I was not. I was trying to avoid him… I didn’t want to hurt him.”
Nemesis Lady stared at her incredulously. “You didn’t want to hurt him? So you intended to hide your relationship with Mr. Douglas from Dr. House until he stumbled on the information? Would you say that, in the long run, your avoidance approach kept him from being hurt… or do you think perhaps he was more hurt when he realized you had hidden the relationship from him?”
Trying not to betray how defensive she felt, Cuddy replied as calmly as she could. “I wouldn’t know,” she said. “He was still fragile, and I thought if he knew I was seeing Lucas, it might set back his recovery.”
The panel chair jumped back in, thank God, but only to reiterate what the female panelist had just mentioned. “We understand that at a medical conference, Dr. House discovered, completely by accident, that you were now involved with his friend, Mr. Douglas.”
“Correct.”
“And that before he learned about your relationship, the two of you had shared a dance at one of the conference events.”
That information could only have come from Wilson. “Yes, that’s right,” Cuddy said, remembering how open House had been with her during that dance, confessing that he had always cared about her, but that he had been expelled from Michigan the morning after their one night together, which was why he had left so suddenly. She had found herself so drawn to him that night… and yet, Lucas was waiting upstairs in their room. That knot in the pit of her stomach made itself known again.
“We also understand that the morning after the conference ended, you and Mr. Douglas had breakfast with Dr. House and Dr. Wilson.”
“Yes, we did.”
“Give us your take on how that breakfast went.”
Cuddy suddenly realized where this was going, and she felt ill, the knot twisting around in her gut. “I… uh… we shared a pleasant meal.”
“How did Dr. House behave at that breakfast?”
“Ummm… well, he was remarkably civil.”
“You sound surprised.”
“I guess I was.”
“Would you say that he seemed to have taken the news you were involved with his friend relatively well?”
“That’s what I thought at the time.”
“Then what happened?”
“That’s pretty much it. Then we all returned to Princeton,” she said, hoping against hope that the panel knew nothing of what had come next. Her hopes were doomed to failure. She heard House’s voice in her head saying, Hope is for sissies.
“From what we’ve heard, that wasn’t exactly how it went, Dr. Cuddy. Isn’t it true that Mr. Douglas taunted Dr. House about his time at Mayfield and the delusion about you that had precipitated it? That he talked about how Dr. House came to be treated as an in-patient at Mayfield?”
Shit, thought Cuddy. Damn Wilson and his big mouth! “I seem to recall something like that,” she said, trying to forestall the inevitable train wreck headed her way.
“How did he learn this information?”
For just a moment, Cuddy considered throwing Lucas under the train, of claiming that he’d bugged her office, or some such thing. But that wasn’t the truth, and for all she knew, they’d talked to Lucas, too. Everybody lies, said that House voice in her head. True, said her own conscience in reply, but that doesn’t mean I have to do it right here, right now. Beside, if I do lie, there’s no guarantee I won’t get tripped up by my lies later on.
“I might have let something slip,” she said, hedging her bet, and hoping against hope that this wasn’t going the direction she was really afraid it was going. “He was a friend of House’s, and he was aware that House hadn’t been around for awhile.”
“As PPTH’s administrator, you must have realized what a serious breach of HIPAA this was… that there was no justification whatsoever for sharing Dr. House’s confidential medical information with your boyfriend. You were part of Dr. House’s healthcare team, and, as such, his medical and psychiatric information was supposed to be kept strictly on a need-to-know basis with other medical professionals.”
Cuddy’s brain whirred, trying to find a way out of the mess she herself had created. “It was a momentary lapse,” she finally settled on.
“A pretty big lapse, Dr. Cuddy. One that was not only unethical by any standard, but had to have been very hurtful to Dr. House, who, as far as we can tell, was working hard on his recovery, and had been attempting to be fairly high-minded in a very awkward circumstance.”
“I’ll admit that it was a big lapse,” Cuddy said, trying to retain her equanimity. Please -- please -- let this not come back to bite me in the butt, she thought. All of a sudden, out of the blue, she remembered just how many times House had admired that very attribute of her body, and she flushed in embarrassment.
Thank God, they dropped that avenue of questioning and moved on. “Once you got back to Princeton, since Dr. House was now aware of your relationship with Mr. Douglas, what happened?”
Cuddy felt on firmer ground here. That was when House had been the one behaving badly, and she was much more comfortable looking at House’s flaws than her own. “He kept trying to interfere in our relationship.”
“As he had with some of your previous relationships?”
“Yes.”
“How did you react to that interference?”
“I expected it, so I didn’t feel the need to react particularly.”
“Tell us what happened at Thanksgiving.”
Cuddy felt her confidence returning. “House tried to finagle his way into my family Thanksgiving dinner… I’m positive he intended to make trouble between Lucas and me. We decided to make sure he wouldn’t be there to cause any difficulties, so I invited him, but said we would be getting together at my sister’s house upstate, rather than at my home in Princeton, which is where we actually held the dinner.” She remembered how pleased with herself she’d felt when she’d come up with that scheme.
“So on Thanksgiving Day -- the one holiday of the year that is intended to celebrate gratitude and generosity -- you sent your disabled employee on a wild goose chase that involved, as we understand it, a three-hour drive, where he received only a cold turkey sandwich for his Thanksgiving dinner… and then another three-hour drive home. Does that accurately reflect what you did to him?”
Ouch. It sounded pretty bad, worded that way. “Yes, I suppose so.”
“Surely, you could simply have told him he wasn’t welcome, without humiliating him and aggravating his disability in that way.”
Cuddy felt that cornered feeling creeping up on her again. “No, no… it wasn’t like that. We knew he would find a way to show up anyway. It was the only thing we could think of to keep him out of the way.”
Ms. Nemesis had a question, which didn’t bode well for Cuddy. “Did you manage Dr. House at work in much that same way, Dr. Cuddy?”
“I beg your pardon?” A now very defensive Cuddy suddenly found herself on alert.
“I mean, were you as manipulative and cruel to him on the job as you clearly were in your personal life?”
Feeling attacked, Cuddy drew in a deep breath. Pulling herself up straighter, she tried to defend herself by going on the attack, a strategy that generally got opponents to back off. “I really don’t appreciate your tone. Dr. House behaved in childish and outrageous ways, so sometimes it took outrageous responses to get him to back off.”
Yeah… like replacing his Vicodin with laxatives. Now that was really mature. Cuddy prayed that Wilson hadn’t mentioned that particular ethical lapse to the committee. She hadn’t thought about the whole laxative-Vicodin-birth control moment for years. To be honest, she’d been trying hard not to think about House at all. But that particular moment, especially in light of the way the panel had been pointing out how walking around aggravated House’s leg pain, was making her cringe. Had she caused him more pain by making him get up and hobble off to the men’s room all day? Oh, well. Served him right. Most of the time, he was certainly a pain in what he might have termed her ample ass.
Nemesis Lady seemed to read her mind. “Really, Dr. Cuddy? As with those mean-spirited so-called ‘pranks’ you pulled on him, it seems to me that your response in this instance was extremely out of proportion to Dr. House’s actions. This shows a serious lack of judgment and compassion on your part.”
“What do you mean?” asked Cuddy, still speaking confidently so that she sounded firmly in charge. She knew exactly what was meant, but she had no intention of admitting it.
“I mean, couldn’t you have found a more benign, less hurtful way to keep Dr. House away? For example, couldn’t you have asked Dr. Wilson to spend Thanksgiving with Dr. House, or one of his fellows or other friends? Couldn’t you have been firm with him about not allowing him to interfere with your new relationship… and stuck by your guns? If you were going to manipulate him, it seems to me that there were plenty of other options, without tricking him and doing it in such a heartless manner.”
That got her. Cuddy swallowed. That lump in her stomach had traveled up into her esophagus. She whispered her response: “I suppose I could have.”
Fortunately for her, the chairman decided to call lunch. “We’ll take a lunch break now, and return at 1 p.m.,” he said. Cuddy nearly ran out of the room.
Day Nine, 1 p.m. - Dr. Lisa Cuddy 4