Chapter Five - "Bird's Eye View"
Before House could make his way around the nurse's station and get to the patient's room, Wilson caught up to him and stopped him.
“Let me see your cell phone,” he demanded.
“What?” asked House.
“Let me see your phone,” Wilson repeated. “And the piece of paper in your pocket,”
“Isn't this a violation of my right to privacy?” asked House as he fished the phone and paper out of his pocket. “At the very least it negates Section 1, paragraph 9, clause 13 of our friendship contract.”
“If we had a friendship contract, I would have renegotiated the terms a long, long time ago,” Wilson said as his eyes darted back and forth between House's cell phone and the piece of paper Lydia gave him. “You did not call her. The last call you made was to someone named Bambi Forest.”
“I had an appointment with her for tonight and I needed to cancel it,” said House fidgeting. “Now come on, give me my phone and the paper.”
“Wait a second… you had scheduled a hooker for tonight and you cancelled because this woman showed up?”
“First of all, her name is Lydia; and second… give me credit for having some kind of class.” House reached over and grabbed the phone and paper out of Wilson's hands.
“You really don't want to mess this up,” Wilson said, amazed.
“Nope. Got any ideas on how I can avoid messing with that?” House nodded his head toward the outer hall of the patient's room. There stood Kyle James dressing down Foreman.
“You told me twenty minutes ago that Dr. House was going to be right here to see my wife and still no sign of him,” ranted James. “I don't like my wife being treated as if she doesn't matter. Or does she have so much wrong with her that you can't figure it out?” Thirteen, Taub and Chase stood to the side, deferring to Foreman to answer the question; but he was no better at it than they would have been.
“Dad, I told you, Dr. House and his team are the best,” said Donald James as he walked out of his mother's room. “I helped Mom research doctors and Dr. House and his team have an incredible reputation. You just have to let them do their job.”
“I like this kid," whispered House to Wilson as they walked over to the group in the hall. “And that's a rarity for me.” Suddenly, James turned and confronted House and Wilson.
“Well, look who decided to show up. I hope you have an explanation for ignoring my wife.” Wilson extended his hand toward Kyle
“Mr. James, I apologize for not having the chance to introduce myself earlier. I'm Dr. Wilson chief of oncology.”
“Oncology?” James said, stunned as he shook Wilson's hand. “Are you telling me my wife has cancer?”
“No… no,” said Wilson reassuringly. “Right now, I'm doing double duty as acting dean of medicine, as is Dr. Foreman.”
“Acting dean? Where's the regular one? Probably knew how screwed up this place was and ran away.” Wilson saw the change in expression on House's face and realized he was moving toward James. He stepped in front of House to block his way.
“She was severely injured in the crane collapse that happened a few months ago, as was Dr. House,” Wilson said quickly. “She, unfortunately, is too ill to return to work.” He glanced sideways at House, who stared at the floor silently. Here it comes, thought House; pity the crippled guy who got smacked in the head with a building.
“I'm sorry. I had no idea.” James took a breath. “I am just so desperate to get some help for my wife, I'm not thinking clearly. All the other doctors we've seen haven't been able to tell us anything. I don't even care what name you want to give it. Just help her… please. I can’t stand to see her suffer the way she is.”
“Mr. James, your concern is completely understandable. Please don't feel you need to apologize for anything,” reassured Wilson. No, he needs to apologize for everything, thought House. “But this morning, a patient of mine…a little five year old girl… reached a crisis. I needed to ask Dr. House for a consultation.” House slowly picked his head up and turned to look at Wilson with amazement in his eyes. He looked over at the team and saw the puzzlement on their faces. “Fortunately, he saw something we all missed. I'm so sorry that it delayed his coming to examine your wife, but I'm sure you understand.”
“Well…of course,” said James. “I didn't mean to… ”
“Just as Dr. Wilson missed something with his adorable little patient, so is it possible my team missed something when evaluating your wife,” House interrupted. Thirteen, Taub, Chase and Foreman all glared at him. “I'd like some time for a private consultation with them. Why don't you and your son go down to the cafeteria; get a hearty meal for him and a cup of decaffeinated coffee for yourself.” After a moment, James reluctantly nodded his head in agreement.
“Alright; let's go Don.” He turned to look into his wife's room, then walked toward the elevators with his son. House walked past the pair, and stood immediately outside the wife's room. He was staring, deep in thought. Wilson came and stood next to House.
“You really don't know where to go with this, do you?” asked Wilson. House shook his head.
“And neither does my usual back-up,” he said turning toward the team. “Anything? Even a far-fetched, screwed up guess would be OK.”
“Well, we did have an idea,” Taub said hesitantly, looking at Thirteen and Chase. “The son traveled to Pennsylvania for an international cross-country meet about three months ago. What if he picked up a viral infection from one of the competitors?”
“Has the son been sick?” asked Foreman.
“Just a cold about a week after returning from the tournament; but what if the son acted as a host and exhibited nothing more than the cold symptoms, and then passed the virus on to his mother who has a compromised immune system. It would explain why none of the antibiotics worked,” Taub concluded. House nodded. He looked at Chase and Thirteen.
“I take it from your silence Taub's ‘we’ is really a ‘he’. What gifts do you bring?”
“The guinea pigs.” said Chase. “Lymphocytic Choriomeningitis.” House regarded Chase with a certain amount of respect.
“Boy, you must have practiced saying that one all day,” he observed. “Isn't that specific to rodents?”
“Yes, but it has been transferred to humans in rare cases,” Thirteen said, “And again, the patient has a poor immune system working against her.” House nodded in agreement.
“But the patient says she doesn't clean the cage; only her son does. She just throws some hay into the feeder for them,” countered Taub. House tilted his head to the side, taking in what Taub said.
“Yeah, but one of the guinea pigs is new. It was purchased a little over two and half months ago from a local pet store which is where they usually contract the virus,” countered Chase.
“Except none of the guinea pigs have been sick,” replied Taub. House suddenly let out a shrill, sharp whistle.
“As much as I'm enjoying the DDX death match, we have a patient to take care of; or did you forget? We can check both theories out. Pull blood from both father and son just to cover all bases. Then go get some piggy poop and see what it grows. Check the rodents for that big long thingamabob Chase said before.”
“You want us to do a blood draw on guinea pigs?” asked Chase.
“Let's see if we can get the son to agree to that. He might be a little hesitant to let us do it,” Foreman pointed out. “After all, we're not veterinarians.”
“They won't remember who he is,” said House as he gestured at Chase. “They're too focused on me and my totally amazing awesomeness. Just introduce yourself as Dr. Doolittle.” Foreman shook his head.
“You know that won't work,” he said. House looked at him.
“Don't you have to go and be a bureaucrat somewhere right now?”
“It might be an idea,” said Wilson. “To go down to the cafeteria and keep things on an even keel with the father and son. We're hitting them up for blood samples from the two of them and the pets. Neither one may react well to the idea.”
“True,” Foreman said. “It might be reassuring to have a member of the hospital administration there to show we're concerned.” House rolled his eyes at the comment. He turned to Wilson.
“Why don't we make it doubly reassuring by having two members of the hospital administration show up?” he said sarcastically. He nodded in the direction of the team and mouthed the word 'go'. Wilson held up a hand.
“OK. I'm going. Call me later.” Giving House a look, he joined the team on the way to the elevators.
“Oh, by the way, don’t forget the really shiny rocks,” House called after him.
“You, too.” Wilson answered. The team looked at him dumbfounded. “I'll explain on the way down,” he said. House turned back to the patient's room. He was giving himself a minute to clear his head before going in. It wasn't the patient's fault he was preoccupied, but it would be his fault if the patient continued to suffer. He quietly entered the patient's room; Bonnie James couldn't see him because she was lying on her left side, facing away from the door. House picked up a chair, placed it by the side of the bed and sat down. Her eyes were closed and there was no movement; just a sound that could only be described as whimpering coming from Mrs. James. House looked up at her IV and saw potassium and sodium bags hanging; he assumed one of the team had ordered them as had been discussed. He saw the slow drip of Dilaudid, and stood up to check the rate of infusion on the painkiller.
“I'm guessing from your cane that you're Dr. House,” said a voice. House glanced down to see Mrs. James looking up at him. House sat down.
“Yeah, but there's a lot more to me than just my cane. There's also my charm and brilliant wit.”
“And I'm told a brilliant mind,” Mrs. James said. “I'm hoping that's true.” House looked away and fiddled with his cane.
“Your son has been more than a little generous with his assessment of me,” he said. “You are certainly presenting me with a unique and interesting case.”
“I'm sick of being interesting. That's the word all the other doctors used.” She had been speaking in a voice barely above a whisper, but now Bonnie James seemed to draw strength from her frustration. “My family has gotten used to a certain amount of limitations from me over the years. But this has taken me away from them. All I can do is lie here and be angry over the fact that I'm a burden to them and no one can do anything. Please,” she said looking House directly in the eyes. “Help me.” Help me. Words that would haunt House the rest of his life. A simple request that was proving so hard to grant once again.
“My team took a lot of information from you, but I'm sure you'll find it much more interesting to talk to me. So, Mrs. James… ” House began.
“You can call me Bonnie, Dr. House.” House nodded.
“And you can call me House, Bonnie.” She managed a little smile.
“I wouldn't be disrespectful. Although it was hard calling Remy, Dr. Hadley when she was here.” House pursed his lips and smiled slightly.
“Yes, I'm sure it was. So, I understand you're allergic to yourself.” Bonnie looked puzzled. “The majority of your ailments are auto-immune,” he explained. As much as she could, Bonnie nodded her head.
“Diabetes, when I was eleven, psoriasis the same year, Rheumatoid and psoriatic arthritis when I was thirty-seven. Fibromyalgia a year later. Looking back on things, I was probably having cardiac problems when I was thirty-nine or forty, but being uninformed, I didn't know what was happening to me.”
“You want to elaborate on that?” House asked.
“I used to be able to walk two, three miles, no problem. Carry laundry, walk up and down the stairs. The arthritis hadn't gotten really bad yet. Then I started experiencing back pain and fatigue. Although the back pain was unusual since it's the knees, elbows, and hands that hurt first with RA, the fatigue was very typical. So, no one thought anything of it. Ten, twelve years ago, they didn't talk much about the fact that women experience back pain as a sign of cardiac distress; all anyone talked about was men and chest pain. Now, they talk about it all the time, thank God. Maybe it'll save a few lives.” House concurred.
“Sometimes the AMA's media machine does a good job. OK,” he said as he stood up. “Time for you to be a brave little soldier.” Bonnie looked fearful.
“Why? What are you going to do?” House looked at the vitals monitor. He saw that her heart rate and BP had started to rise just with anticipation of the pain.
“Just show me where the pain is. ‘Cause my team seems to think it's only right here.” House indicated the right side of her head and face. Bonnie took a deep breath before she began.
“Starting here,” she said pointing to the middle of her forehead at her hair line, "Go down to here, at the end of the nasal bone, on the right side only. It comes across here,” she said running her finger along the bottom of her eye socket. “It goes over to my ear. Now go up to the top of my head, right in the middle of the skull and draw a line back down to my hairline where I started. That's it. If I could just…remove that part of me, I would feel a thousand percent better.” House nodded.
“Removing it would be really cool; except it's too early to get ready for Halloween. Although, from what you're describing, every bar in the area would give you first prize.” He reached over to touch her face and heard her draw a breath in. “I'll be as gentle as I can. So this,” he said putting pressure on her right eyebrow, “Hurts. But this, doesn't,” he said as he placed his hand on the back of her head. She was literally shaking from the pain of House's initial touch.
“Yes, that's right.”
“And the pain is excruciating.”
“Oh, you have no idea,” Bonnie said. House smirked.
“Yes I would. More than you'd know.” He could feel her gaze on him, looking him over and down at his leg; but he chose not to return her look.
“Have you had a problem with your leg your whole life?” House sat down and rested his chin on the handle of his cane.
“No, the problem developed several years ago.”
“It changes you,” she noted. “The pain I mean. I'm not the person I used to be. Right after my husband and I met, he said that getting me drunk on champagne would be redundant.” House smiled. “No one would say that about me now. And it's not just this… thing that's happening to me at the moment… it's the pain from the RA and the Fibro. I still manage to enjoy some things, but that's because I have my husband.” She looked away. “I know he's been driving you a little crazy and I apologize.”
“I think a pack of Chihuahuas after a visit to Starbucks would be less annoying,” commented House. Bonnie smiled.
“He's a good guy. He's seen me at my best and he seen me at my worst,” she said indicating the hospital bed, “And he hasn't walked away.” House looked her with curiosity.
“Did he know what he was getting into?” he asked.
“All the other guys I dated, once they knew what life with me would be like, they couldn't handle it and left. I was just a diabetic back when Kyle and I met; none of the other stuff had come out. He asked and I told him of all the possible complications. I told him my whole family history; my mother had Multiple Sclerosis, my father had heart problems and my brother was a diabetic. Twenty-four years later, he's still here.” She winced and moved her hand up to her forehead and nose. “Pain's getting bad again.”
“I want to finish here before I up your pain med. Otherwise Lucy in the sky is going to float by with Major Tom trailing right behind. You're really going to hate me for this.” And without giving her a chance to protest, House stood up, quickly pulled the draw sheet on the bed and rolled Bonnie over to her right side.
“Oh no… please don't! Oh God! No! Please move me back!” The intense pain was instantaneous.
“I can't. It's just as I thought. You're already developing skin irritations from being on one side all the time. You don't need any other part of you screwed up.”
“Please, my husband is a nervous wreck as it is. Please don't let my family see me like this. Oh, God, the pain… ”
“What the hell is going on?” Kyle James asked as he stormed into his wife's room. “What have you done to her?”
“She has the beginning of bed sores from being on her left side all the time. She needs to take the pressure off or we can add that to her list of complaints.” Wilson and the team had entered the room as had the James' son.
“’List of complaints?’ Is that what you call what my wife is going through? You bastard!” James yelled, “You have some nerve to come in here and act like this isn't serious.”
“Mr. James, please take it easy. I can assure you that Dr. House is taking this quite seriously and is doing all that he can,” said Wilson.
“Well, obviously, it's not enough,” said James.
“Dad, come on, calm down; the best way you can help Mom right now is to let them do the blood tests they need. If you don't take it easy, they'll never get the blood out of you. You get nervous just talking about needles.” Bonnie James let out a surprisingly loud cry.
“Please just do what they want, honey. Help me.” Those two words again. House was growing to hate them more and more.
“Mr. James, why don't you come with us and let us get the blood tests started,” Thirteen said. “Your son can stay here for now and keep your wife company.” A rambling clutter of different conversations filled the room; James, Thirteen, Chase, Wilson, all of them talking over each other. Bonnie James’ crying was the only sound House focused on. Why couldn't he break this? He vaguely heard both Kyle James and his son arguing with each other and the team. What was he missing? He became aware of Wilson standing next to him.
“I've got one good nerve left and that guy is standing on it,” Wilson said quietly.
“Yeah, he's really… ” House stopped. He stared off past everyone in the room. One good nerve left. Got some nerve. The pieces were falling into place and making the border, at least, of a picture.
“Has your wife fallen or hit her head right before this started?” James stopped yelling. He looked taken aback.
“Not that I'm aware of,” he said. House looked at Don James.
“You know anything about your mom hurting her head, neck or back?”
“No. I mean she falls every once in a while on days when her arthritis is bad.”
“Has she fallen more as of late? Hit her head?” House asked urgently.
"Where are you going with this?" Wilson asked. House walked over to Taub and spun him around so that he faced everyone in the room.
“She says the pain goes from here, to here, to here, to here,” said House as he traced the same outline on Taub that Bonnie did on herself. “What does that indicate?” House looked from one team member to another.
“A nerve trunk,” said Chase.
“Probably at the C-3 vertebrae given the location of the pain,” Thirteen said.
“The question now is what happened?” Taub said. House walked over to Bonnie.
“Have you fallen and hit your head recently?” House asked Bonnie. “Back just before this started?”
“No,” she said as she continued to cry. “Please put me back on my left side. Just while my family is here.” House leaned down to her.
“Are you sure you didn't fall? Hit your head?”
“Yes, I'm sure,” she said getting angry, “I'm with my body all day long. I'd think I'd know if I fell. Please put me back.” House straightened up and gestured for Thirteen and Taub to move Bonnie into a more comfortable position. He walked over to Kyle James.
“I don't know what's wrong with your wife, but I know how to give her some temporary relief.” House turned in the direction of the bed. “Something has either damaged or inflamed the nerve root of the C-3 vertebrae. My first thought was trauma, but since she hasn't fallen, that's not a likely cause. However,” he said sounding a bit more positive than he had. “We can start her on Neurontin. It has minimal side effects and will block most of the pain. It'll buy us some time while we figure out what the cause really is.” He turned to the team. “Start her on 300 milligrams, every eight hours. And get some Memory Foam under her to relieve the bed sores.” House walked over to Bonnie's bedside. Her crying has subsided since she had been moved onto her left side.
“I'm going to put the kitchen on alert. They normally don't stock champagne,” he said. “But I always enjoy watching intoxicated behavior in others.” She managed a smile.
“Please don't tease me.” House shook his head.
“I'm not; you should start to feel better soon. Now I just have to figure out how to keep you that way.”
“Hold that thought,” House said as he went to move away from the bed. He found himself face to face with Kyle James. The two men stood looking at each other for a moment.
“My son was right about you,” James said.
“Not yet he isn’t,” House replied. He walked out of the room followed by Foreman and Wilson.
“I’m surprised… concerning yourself with the comfort of the patient?” Wilson said.
“That’s only because bed sores are a pain in the ass to treat,” responded House.
“I never would have guessed a neurological issue,” said Foreman. “Everything pointed to the sinuses.”
“Yeah and you were accusing her of being a wuss who had no tolerance for pain,” snapped House. “Believe me she understands pain as well as I do.” He took a deep breath. “I need to get some fresh air and something to eat. If she has any problem with the Neurontin call me. If she's OK with it, lose my number.” As he walked away he reached into his left pocket.
“House?” Wilson had come up behind him. “You've still got it.” House frowned.
“Don't get me wrong; I like the patient. I'm glad we've made some progress. But I care more if I still got it somewhere else,” he said as he drew the piece of paper from his pocket.
House turned and left to keep his luncheon date.