CHAPTER SIXTEEN: INTERPRETATIONS ON AN OVERSIGHT
Chase enters the Diagnostics office and stops short; Foreman and Cameron are here, and they’re looking at him expectantly.
“What are you two doing here?” He’d come to the office seeking solitude, and now he’s going to have to deal with their attitudes about his oversight.
“You really thought we’d sit at home after you called us about House?” Cameron asks.
“No. I… uh… actually, I guess I’m glad you’re here.”
“He’s worse? What’s going on?” Cameron rises from her chair, evidently ready to head for House’s room.
“His condition’s deteriorating; we’re transferring him to the unit, but he’s okay for now. There… was a problem, though….”
Neither Foreman nor Cameron speaks; they simply look at Chase, waiting for him to go on. He sighs and sits down. “He wasn’t on pain medication for almost nineteen hours. Started to go into withdrawal, and no one knew. Dr. Wilson finally realized, and… he’s pretty upset.” Chase falls silent.
“How’d that happen?” Foreman asks him.
“I’m not sure. He was acutely ill when he came in last night; the main concern was getting him dialyzed, and I guess Cuddy’s focus was the renal failure. Didn’t occur to her to order anything to replace the Vicodin. And when she called me in today, I went over his chart and we discussed the meds, but….” Chase stops speaking, doesn’t seem inclined to go on.
“You didn’t think about it either,” Foreman concludes. “And Wilson was more concerned with House, the friend than House, the patient, so it took withdrawal to make anyone take notice.” Foreman chuckles softly.
Chase is incredulous. “He’s gonna rip into me for this, make my life miserable! What are you laughing about?”
“House’ll be pleased; the old bastard’s gonna take it as a compliment.” As Chase and Cameron stare at him in confusion, Foreman continues, “His twisted psychology worked! He’s spent all these years harping on his damned leg for a reason; he figured eventually we’d tune ‘im out, get on with our jobs, just see him as number one on the Worst Boss In the World hit parade, instead of some pathetic cripple in need of coddling. And it worked! Well… mostly worked,” Foreman says, glancing sidelong at Cameron, who glares back at him.
“So he’s not gonna kill me?” Chase asks hopefully.
“Oh, yeah!” Foreman grins. “You’re still gonna catch holy hell for it. But you can take comfort in knowing that deep inside, he’s thanking you for forgetting. Real deep inside.” Foreman laughs at the look of dismay that’s replaced the hope on Chase’s face.
“Well, I don’t see anything funny about this.” Cameron is indignant. “Whatever else you think of him, House is a human being who was made to suffer unnecessarily. And Chase should feel awful. As doctors, we’re charged with the responsibilities of causing no harm, and alleviating pain. Chase failed at both!”
Now Chase is annoyed. “Thank you, Dr. Cameron, for that Cliff Notes version of the Hippocratic Oath! And you’re causing pain right now; didn’t you think I felt bad enough before your little sermon? Just thought you’d twist the knife in a bit deeper? Wonder what Hippocrates would think of that!” Chase and Cameron try to stare each other down across the table.
“Okay, you two, enough. Chase, c’mon, tell us what’s going on with House. Why the unit? Got the labs?”
“Chart’s with Cuddy; she’s overseeing the transfer. He’s tachypneic and his sats are dropping. Renal function’s about the same; he’s putting out about 20cc an hour. BUN and creatinine were through the roof when he was admitted; been a slight decrease since. Got some immune assays pending; turns out he’s been on prednisone for a couple of months, problem with his shoulder. But we already know the basics there; white count’s depressed, immune system’s definitely been compromised by the pred. He’s also tachycardic—but he’s febrile, running 102, 103, so I’m not concerned with that yet.”
Foreman hasn’t heard anything that would warrant ICU, so he repeats the question. “So why the unit?”
“Mostly for Wilson. As soon as House’s respiratory rate started climbing, and his oxygen saturation dropped a couple points, Wilson wanted him on a vent. So I told him we’d put him on O2, and monitor his status in ICU. Wilson’s taking this hard, and now, with the pain med mix-up…. Let’s just say it’s for Wilson’s peace of mind.”
Both Foreman and Cameron nod their understanding. “And the MRSA?” Cameron asks.
“Because of the kidney failure, we’ve had to withhold the vancomycin. He’s covered; it’s still in therapeutic range. They pulled new blood cultures on him last night when he came in with the fever; no results yet on those. Bottom line is, we’re in a holding pattern. Not bad, not good. He’s pretty sick, but right now there’s not a hell of a lot we can do for him.”
“I know one thing we can do for him,” Cameron says. “We need to go see him. He needs to know that all his friends are there for him, supporting him.”
Foreman and Chase roll their eyes at each other, and Foreman whispers, “You wanna get back in Wilson’s good graces? Keep her outta there!”
Chase shakes his head at Cameron. “Wilson’s superglued himself to House’s side, so ‘all his friends’ is already there. And you’d do well to stay out, at least for a while. Cuddy’s with him too—and I have a feeling Wilson isn’t done yelling about the oversight yet.”
“You’re a coward, then, letting Cuddy take the heat,” Cameron says. “And it’s not the oversight; it’s your oversight. You should be right there with Cuddy.”
“Oh, no!” Chase shakes his head vigorously. “You know how Wilson is about House’s health; he’s appointed himself personal guard dog. Makes all the big decisions, even controls the meds. And House lets him get away with it. And currently, House’s guard dog is feeling guilty for falling asleep on the job, letting his friend suffer. He’s gotta pin the blame on someone to make himself feel better. Why should it be me when Dr. Cuddy’s already right there in firing range?”
“Coward,” Cameron mutters again.
“Yeah,” Chase tells her, unperturbed. “But at least I’m a coward who’ll live to tell about it. Can’t say the same for Cuddy, once Wilson gets done with—” He’s interrupted by the sound of his pager, and reaches into his pocket for it.
When he looks up at his colleagues, his eyes are wide. “It’s House; let’s go!”