Denial Isn't a River in Egypt - Part 3/?
Title: Denial Isn't a River in Egypt (3/?)
Rating: R (for occasional use of profanity)
Spoilers: Through Who's Your Daddy; all subsequent episodes are just figments of your imagination. :)
Disclaimer/other: See Part 1
Previous entries:
Part 1 Part 2
Pulling his damp T-shirt away from his chest, House uttered an array of profanities as he entered the conference room. How dare Wilson barf on him! He didn't care if the idiot wanted to be a martyr and show up for work sick as a dog, just as long as it didn't affect him in any way, shape, matter or form. Projectile vomiting definitely affected him. The acrid stench made him want to heave, not to mention want to choke the living daylights out of Wilson.
"I'm going to kill him," House hissed as he ripped a handful of paper towels from the holder and began removing bits of partially digested food from his shirt.
Chase wrinkled his nose in disgust at the offending odor. "What happened to you?"
"Wilson happened! He threw up on me in the elevator."
Cameron frowned. "What kind of bug does he have now?"
House tossed the soiled paper towels into the wastebasket, pulled several fresh ones off the roll and resumed dabbing at his clothes. "Don't know, don't care."
"Yes, you do. He's your friend."
"Not anymore."
"Did you even offer to prescribe anything for Wilson's nausea?" Foreman asked. "Or do you just plan to bitch about it all day?"
After appearing to give the matter some thought, House finally replied, "I suppose I could give him some cyanide."
"That's not going to solve his problem."
"No, but it will certainly solve mine."
"I wonder why Dr. Wilson keeps getting sick?" Cameron mused aloud.
As he wiped a rather large clump of emesis off his blue jeans, House mocked her concern in a voice dripping with sarcasm. "How sweet of you to be worried about the vomit-spewing troll!"
Cameron ignored his withering glare while she defended her remark. "Of course I'm concerned. People just don't get this many infections unless there's a reason."
The previous day's conversation still fresh in his mind, House couldn't resist getting in a dig at Wilson's expense. "Maybe his frequent illnesses are just a physical manifestation of some unresolved psychological issues. After all, a guy that's been married three times isn't exactly firing on all cylinders."
Chase held onto the glass tabletop with his fingers, leaning back in his chair so that only the back two legs rested on the floor. "Maybe we should do a DDX on him," he suggested.
"I've already offered. He said no."
"Was that before or after you told him to stop wasting your time with his, and I quote, 'ridiculously trivial complaints'?"
House bristled at the suggestion that he was partly to blame for Wilson's current predicament. "After he started wasting his time seeing Ira Schwartz," he shot back.
Scrunching his nose, House contemplated his pitiful state. His leg hurt, he reeked of vomit, and he didn't have any clothes to change into. So, instead of collapsing into his comfortable lounge chair with his bag of popcorn and propping his leg up on the ottoman, as he had planned to do, now he had to make an agonizing trip to the locker room, take a shower, and change into a pair of scrubs. Then by the time he made the arduous trek back to his office, his leg would be throbbing and the malodorous scent would still be indelibly burned into his brain. Just what he needed to make an already crappy day even crappier.
"I'm going to go get cleaned up," he announced to no one in particular as he headed out the door. "If Cuddy calls, tell her she can save a few cents on this month's water bill if she'll join me in the shower."
House quickly dry-swallowed a couple of Vicodin as the door closed behind him. He was still indignant about Wilson's plan to wean him off the drug and substitute it with something woefully ineffective. With friends like that, who needed enemies? If there were any justice in this world, House hoped that Wilson was suffering at least half as much as he was right now.
An hour later, House was in remarkably different frame of mind. A long, hot shower, a change of clothes and a generous dollop of Vicks VapoRub under his nose had done wonders to eradicate the stench of vomit from his conscious memory, and the Vicodin had finally kicked in, making the pain almost tolerable. Unfortunately, a guilty conscience couldn't be assuaged with a little soap and water, or a couple of pills.
House was starting to feel a twinge of remorse for taking his frustrations out on Wilson, even if he was still pissed about the overreaction to his lab results. But he couldn't humble himself to say, "I'm sorry." That wasn't how their peculiar relationship worked. House never apologized for his transgressions, and Wilson always forgave him, eventually. It was simply their way-a tacit, albeit dysfunctional, arrangement.
However, House rationalized that it wouldn't be a violation of the rules if he presented some kind of a peace offering. So he stopped by a vending machine and bought Wilson a 7-Up to help settle his stomach, and a package of Cheez-its, which was the closest approximation to saltine crackers that he could find. Then he set out to deliver his purchases, and to obtain absolution.
House knew exactly where he'd find the ailing oncologist. In his office, chained to his desk, and possibly hovering over the trashcan. He opened the door and poked his head inside. "Are you decent?"
"Are you?" Wilson asked, looking up from his paperwork.
"Never. I have a reputation to uphold, you know." House set the soft drink and bag of cheese crackers on the desk and sat down. "I thought this might help with the nausea."
Wilson smiled. The penitent gesture had been accepted, and all was forgiven. He opened the 7-Up and took a small sip. "If word gets around that you just performed a good deed, it might undermine your curmudgeonly mystique."
"That wasn't a good deed. It was self-preservation. If you don't puke on me again, I don't have to take another shower and change clothes."
"Uh, sorry about that."
House shrugged off the apology. "It's okay. But maybe we should go in separate elevators for the time being, at least until your aim improves. You could use Ira Schwartz for target practice."
Wilson groaned in frustration. "Why do you hate Ira so much, anyway?"
"I don't hate him," House protested. "I just don't think Ira could find his ass with both hands, a three-way mirror, a map, a compass, GPS technology, and the National Guard."
"House..."
"Well, he doesn't seem to be doing you any good." House rested both hands on his cane as he scrutinized his friend's appearance. "You look like hell. How do you feel?"
"Nauseated from the vertigo, but mostly embarrassed," Wilson admitted.
"Do you need me to write you a script for something?"
"No, thanks. I've got it covered."
"Care to elaborate upon that?"
Wilson tiredly rubbed his face with his hands. "After I threw up on you, I went to see Ira. He confirmed what I already suspected, that I have another case of labyrinthitis on the right side. Ira gave me a shot of Phenergan for the nausea, which seems to be helping. He also prescribed some oral Phenergan, meclizine for the vertigo, and prednisone to try to minimize the damage from the inflammation. Oh, and he switched me to another antiviral. It's debatable whether or not the valacyclovir will be of any benefit at this stage of the game, but it's worth a try."
House grudgingly acknowledged his approval. "Well, even a stopped clock is right twice a day. But I'd feel a whole lot better if you'd let us do a workup on you."
"I'll keep that in mind."
"I'm serious."
"I know. It's just that..."
"Just what?"
Wilson kept his eyes focused on the label encircling the plastic soft drink bottle while he tried to come up with a plausible excuse. "There's really not much you or anyone else can do. I just have to ride it out for a few weeks until I can get a handle on the vertigo. This isn't exactly unfamiliar territory." He took another swig of 7-Up and looked at his watch. "I think I'm going to cut out of here in about half an hour and go home, take my meds, watch TV, sleep, try to eat, and generally take it easy this weekend."
House knew he was being brushed off, but decided to let it go, for now. "Sounds like a plan," he remarked. "The rest will do you good."
"Yeah." Wilson was relieved that House hadn't pressed the issue. He laced his fingers behind his head and leaned back in his chair. "So how are you doing? Are the Medrol and Flexeril helping at all?" he asked hopefully.
Now it was House's turn to be evasive. He had started the corticosteroid yesterday, but hadn't bothered with the muscle relaxant. However, Wilson looked so tired and frail that House didn't have the heart to tell him that he hadn't taken it. He wiggled his hand in a seesaw motion. "Kinda hard to tell after only one day."
Wilson sighed loudly. "True. I guess that would be expecting too much too soon."
House didn't know why the little white lie made him uncomfortable. After all, everyone lies, right? So why did he feel guilty about telling only half the truth, especially when Wilson had been less than honest with him about his reasons for declining a diagnostic evaluation? Shouldn't he just consider them even? Or did the motive behind the prevarication make a difference? House had merely wanted to hide an unpleasant truth to spare his friend's feelings. What was Wilson hiding, and why?
Fortunately, puzzles were House's forte, and this was one that he fully intended to solve. His first order of business was to collect more pieces of the puzzle to analyze, starting with Wilson's medical records. Eager to get started on his research project, House rose to his feet as quickly as the building muscle spasm in his leg would permit. "I guess I'll leave you alone so you can do whatever it is that you need to do before you go home and turn into a drugged couch potato. Give me a call if you need anything this weekend."
"Will do," Wilson promised, his attention immediately drifting back to the stack of papers he had been working on earlier.
House felt strangely conflicted as he left the room. A challenging new case always provided a certain sense of exhilaration-the thrill of the hunt as it were-as he formulated hypotheses and eliminated possibilities until he arrived at a definitive diagnosis. Except, this time, his enthusiasm was tempered by his relationship to the patient, and a growing sense of dread at what he might find.
By Sunday evening, House was beginning to reconsider his decision to forego the muscle relaxant. Not to humor Wilson, but because Vicodin alone didn't provide adequate relief from the unrelenting muscle spasms. He had been pacing throughout his apartment for the past thirty minutes, desperately trying to ease the fierce ache in his thigh. The pain was the worst it had been since the shopping cart incident, and he hadn't even tried to scale back on his dosage yet. House felt trapped between the proverbial rock and a hard place. If he took more than the prescribed amount to dull the pain, he'd run out in less than a week. Conversely, if he took the recommended 80 mg. a day, then he'd just prolong his misery. There had to be another alternative-one that didn't include the secret stash of morphine he kept on hand for extreme situations.
House ceased his frantic pacing and sank down on the couch. He grabbed the bottle of Flexeril from the coffee table, turning the amber vial over in his hand as he weighed his options. House wasn't really sure why he was so reluctant to take the muscle relaxant. Was he afraid that it wouldn't work, or was he afraid that it would? If it worked, then it could be argued that Wilson and Cuddy were right, that Vicodin wasn't the only drug that could manage his pain. Then they might jump to conclusions and assume that other medications and treatments could be equally effective.
He didn't have any objection to taking the anti-inflammatory. Diffuse swelling could be objectively identified on an MRI, and therefore quantified. But the muscle relaxant was a two-edged sword. Pain was subjective. He didn't have a computer-generated image or a printout to prove how much his leg hurt. All he could do was hope that someone believed him when he insisted that he was in severe pain, and that Vicodin was the only drug that made it bearable. So if Flexeril relieved the spasms related to the recent injury, then he ran the risk of sabotaging his credibility. Oh, why did something as simple as a muscle relaxant have to be complicated?
Setting the bottle back on the table, House cursed himself for submitting to the lab work that had caused all of this trouble in the first place. He had been so focused on getting his prescription refilled that he never even considered the consequences. House laughed bitterly as he immediately dismissed that excuse. Oh, who was he kidding? Of course it had crossed his mind that something might turn up. That's exactly why he kept putting it off. He had just gambled that Wilson hadn't been serious about the lab work, and lost. Damn it, all of the stupid times for the bastard to grow a pair!
Maybe he should insist on repeating the blood tests before Wilson did something drastic, like take away his Vicodin. Glitches happened all the time. Maybe the lab had gotten his paperwork mixed up with someone else's. It was possible. Not necessarily probable, but possible. But at this point, he was willing to grasp at straws to forestall any proposed medication change.
House slid his hands under his right thigh and lifted his leg onto the coffee table, and in the process, knocking the Xeroxed copy of Wilson's medical records onto the floor. He lamented the dearth of useful information as he stretched forward to pick up the sheets of paper. Either Ira Schwartz was a man of few words, or the family practitioner had colluded with his patient to keep the paper trail to a minimum. The chart only contained copies of a few lab reports and sparse notes limited to vital signs, sketchy details of each illness he had treated, and the medications prescribed. House wasn't sure if he should be relieved or worried. Maybe there was no 'there' there, and he was guilty of overreacting to Wilson's situation, just as Wilson had overreacted to his.
However, House couldn't shake the nagging feeling that something was seriously wrong, and he planned to find out what it was. But first he had to get the pain under control so he could get some sleep. He wearily turned his wrist and noted the time on his watch. It was only 10:05, and he had already taken 100 mg. of Vicodin during the past eighteen hours. Taking two more wasn't going to cause him to go into liver failure before morning, but without being assured of his next refill, he had to mete them out judiciously.
He slumped in defeat as he reached for the bottle of Flexeril and shook two of the pentagonal orange tablets into his hand. They looked so small and innocuous, and yet they threatened so much. House wasn't sure he wanted to have his worldview shattered if the pills worked. And although the muscle spasms in his leg were extremely painful, he couldn't justify self-medicating with morphine. So unless he wanted to knock back a several shots of whiskey, the Flexeril was the only viable solution at the moment.
House tilted his head back and swallowed the tablets before he lost his nerve. Then he pulled himself to his feet and resumed pacing back and forth. If the pills didn't make him sleepy, then perhaps exhaustion would.
Wilson leaned against the bathroom sink, splashing handful after handful of cold water on his face, trying to wash away the traces of sickness after throwing up yet again. Over the weekend, he had repeated this sad ritual more times than he cared to remember, and there appeared to be no end in sight. How did he expect to make it in to work in the morning when he could barely make it to the toilet bowl in time?
He grabbed a fresh towel from the wicker étagère, wincing as he caught a glimpse of his reflection in the mirror. His skin had taken on a sickly, grayish pallor, emphasizing the dark circles under his bloodshot, sunken eyes. He looked like hell, but then again, he felt like hell. The vertigo, nausea, and vomiting were taking their toll, and if his last bout of labyrinthitis was any indication, he probably had about seven or eight more weeks of this ahead of him. Oh joy.
In retrospect, Wilson wished he hadn't talked Ira Schwartz out of prescribing the antiemetic in suppository form. Then maybe he could have kept the rest of his medications down, as well as food and much-needed fluids. Unfortunately, after that shot of Phenergan, Wilson had been so sure he'd be able to tolerate oral medications that he had allowed misplaced optimism to take precedence over common sense. Now he was badly dehydrated, and he had no one to blame but himself.
It would probably be a good idea to go to the emergency room and let them run an IV, and maybe give him an injection of something for the vertigo and nausea. But the thought of having to get cleaned up and dressed was too overwhelming to even consider. Besides, with his luck, some overeager resident would want to admit him and run a bunch of tests, and that was the last thing he wanted.
Wilson glanced up at the bathroom clock. It was already 10:15, and for all practical purposes, the weekend was almost over anyway. If he could just tough it out for a few more hours, he could stop by the clinic in the morning and have Ira, or whoever was available, give him another shot. And while he was at it, he could ask for a prescription for the suppositories that he had so foolishly rejected earlier.
A few hours ago, he had almost broken down and begged House to prescribe the medication for him. But ultimately, Wilson couldn't bring himself to do it. Three days ago, he had not only refused to believe that House really needed as much Vicodin as he claimed he did, he had had the audacity to presume that the pain was at least partially psychosomatic. Under the circumstances, Wilson felt too embarrassed to plead for a little pharmacological relief when his own life was a total disaster.
But that wasn't the only reason he was afraid to ask House for help. Wilson suspected that he had a much bigger problem than just another inner ear infection which had gotten out of hand. Dozens of possibilities had crossed his mind during the past several months, some of them relatively benign, and some of them not. It was that second category that worried him, which was why he wasn't too eager to submit to the extensive workup that House had proposed.
Intellectually, Wilson understood that his fear was not only irrational-it could be deadly. He had seen far too many patients wait too late to have a suspicious lump or other worrisome symptom evaluated, usually with tragic results. On the other hand, he realized that he could probably save himself a lot of unnecessary anxiety if he'd just agree to the evaluation. Maybe there was a simple explanation for everything, and whatever was wrong could be easily treated. Then he'd kick himself for not having it taken care of earlier.
Whatever the case, Wilson knew he wouldn't be making a decision anytime soon. He had more a more urgent dilemma that required his attention. Bracing his abdomen with his left hand, he leaned over the commode and heaved into porcelain bowl.
Part 4