First of all, please allow me to apologize for the delay in posting; I was stuck in a hotel room in Gainesville, FL yesterday morning due to a wildfire in the Ocala forest--so we'll call the delay an Act of God! hee.
The Devil's In the Details again centers around the House-Wilson-Cuddy bond. The story has a lot of introspection, especially for House and Wilson. The plot (such as it is....) centers around House's undiagnosed left leg pain.
Disclaimer: Imagination and mistakes--mine. House M.D. et al--Fox, Shore et al mjf
THE DEVIL’S IN THE DETAILS
CHAPTER ONE: Evasion
Wilson leans back against the couch with a satisfied sigh. Cuddy’s just left for the evening, House is engrossed in a television program, and it’s been a really good day—the first really good day since he and House had returned from the hospital Sunday evening, after the procedure to control House’s breakthrough pain.
Hard to believe we’ve been home only four days. So much has happened. Not even a full week since House collapsed in front of his team. But we pulled it off. When House goes back to work in a few weeks, all they’re gonna know is he’s not in so much pain. Wilson looks over at the subject of his thoughts, studies him for a moment unobserved.
House is still gaunt, pale, underweight. To anyone else, he’d probably simply look frail and crippled. But Wilson sees something else, something far more important. House’s eyes are alive again. The smoldering anger that had been there for months is gone now, and the flat indifference that’s been there all week has been replaced, too. Humor’s returned to his eyes, and interest. But even more important, Wilson knows, is the brand new sense of security that’s just starting to radiate from those honest blue eyes, a sense of safety that Wilson hasn’t seen since the infarction.
Wilson had gone to see a psychologist on Monday, his old college roommate, Richard Dickinson. And Dick had told him that all these positive changes would occur. But he’d also warned Wilson that the success of the pain control procedure could bring with it some serious negative consequences for House.
Dick’s wrong. House isn’t having any problems with self-perception. He’s not grieving the loss of the breakthrough pain at all. Don’t even think I need to discuss that aspect of it with him, in spite of what Dick suggested. He’s handling it well enough on his own. No angry outbursts, no lashing out at me. Not gonna try to fix something that isn’t broken; sorry Dick. We’ve navigated enough real problems in the last six days without creating another difficulty where none exists.
“Want a snack? Something to drink?” he says now to House. House is ending his first twenty-four hours of being on total parenteral nutrition, but he’s been on an effective anti-emetic, Zofran, for two days now, and today he’s finally had an appetite, and has been able to hold the food down. Wilson doesn’t want to push, but he knows that House is anxious to be weaned down to the TPN administration only at night. And the only way they’re gonna get there is for House’s emaciated body to relearn the signals of hunger that the pain had suppressed for so long.
“Just finished dinner an hour ago,” House reminds him. “But maybe a cold drink?”
“You’ve got it,” Wilson says, getting up and heading for the kitchen. “Gimme a couple of minutes to wash up the dinner stuff, okay?”
“Not a problem.” House doesn’t even look at Wilson; it seems he’s already reabsorbed in the program. Wilson smiles, savoring the normalcy of it all.
As soon as Wilson is out of the room, House’s relaxed demeanor falls away as he clamps both hands tightly around his left thigh. Thought he wouldn’t get outta here in time, couldn’t’ve left it alone a second more. He presses deeply into the thigh with the palms of both hands, trying to break the tightening grip of the painful spasm. His face contorts and his eyes close tightly as he leans forward in a self-protective motion. What the hell is happening?
“Root beer okay?” Wilson calls cheerfully from the kitchen.
House forces himself to pull in a deep breath so he can answer in a normal voice. Not gonna let this garbage ruin the day for him. Hasn’t sounded that happy, that relaxed, in months. And as House forces the air into his lungs, the grip of the spasm breaks, and the pain is gone. So the tone of House’s voice more than matches Wilson’s when he yells back, “Root beer’s great! Got any vanilla ice cream to put in it?” House hears Wilson laugh, with real joy.
“That’s an affirmative!” Wilson shouts. “Keep this up, we’re gonna need some more food soon.” House can actually hear the smile in Wilson’s voice, and it makes him smile too, and forget, for a minute, his promise to himself to tell Wilson about the leg tomorrow. Maybe tomorrow, the familiar clenching pain will be gone.
I fell that first night home; could’ve pulled a muscle. And all that damned retching, vomiting. Wouldn’t be the first time I wrenched something doing that. Could still be nothing. House pushes away the loudest voice in his brain, the medical voice that’s telling him that this pain isn’t related to anything simple.
Wilson enters the living room carrying two root beer floats on a tray, and he’s still smiling. “Won’t be long before we can trade these in for real beer,” he tells House as he hands him a glass.
“You can have the real stuff,” House reminds him.
“Oh, no. The next beer I drink is gonna be to celebrate with you.” Wilson’s cellphone rings then; he sets down the tray and checks the caller ID. It’s Cuddy; his intuition tells him to take the call out of House’s hearing, so he heads back into the kitchen.
“I didn’t get a chance to tell you that House seems to be having trouble with the left leg,” Cuddy tells him. “He blamed it on that epi injection from the anaphylactic reaction, but I’m not buying it. I’d intended to check into it further, but then you came back to the apartment, and it just seemed like a better idea to let him have a day where the focus wasn’t on his health.”
“Gotta agree with you there,” Wilson says. “He’s more relaxed than I’ve seen him in a while. As a matter of fact, he’s actually drinking a root beer float right now!”
Cuddy laughs. “Hey, the more calories, the better. Maybe you should just let the leg thing go ‘til tomorrow. Whatever it is, it’s intermittent, and it doesn’t appear to be getting any worse, so I don’t think waiting would cause any harm.”
“Sounds like a plan to me. I’m just disappointed, I guess, that he hasn’t mentioned it. It was starting to look like we were moving past all the distrust issues.”
“I still think we are,” Cuddy says. “This is House; if this thing with his left leg is new, he may still be denying it to himself, downplaying it in his own mind. If that’s the case, then he wouldn’t be ready to mention it to anyone yet.”
“Good point,” Wilson says, with some relief. “I’ll just leave it alone until tomorrow, then. To tell you the truth, I’m enjoying this day, too. Not anxious to say anything to him that might ruin it.”
Wilson concludes the conversation with Cuddy, and returns to the living room, where House proudly holds up his empty glass for Wilson’s inspection. Wilson smiles his approval, and refrains from asking how House is feeling. Just be his friend tonight, he tells himself.
House sets down the empty glass, and tries, unsuccessfully, to stifle a yawn. “Wanna watch that O.C. episode you missed the other night?” he says, through a second yawn.
How can I get him to realize he needs some rest without sounding like Dr. Wilson? Wilson yawns extravagantly himself, rubs his eyes, and stretches. “No; if it’s okay with you, I’ll just doze in the chair while you watch it. I’m pretty beat, but you go ahead and watch your show.”
House looks relieved that Wilson’s admitted to being tired; he immediately shuts off the television. “No, that’s okay. I could use some sleep too,” he says.
As he rolls the IV pole to help House get to the bedroom, Wilson covertly watches House’s gait. He’s satisfied that there’s nothing abnormal going on, at least not right now.
Wilson helps House get settled in bed, then does an assessment and gets the last lab draw of the day. It’s become routine the last few nights for him to sit by the bed until House falls asleep, and as he gives the package to the lab courier, he wonders whether or not House will want him there tonight.
When he returns to the bedroom, he smiles at the answer to his question; House is already soundly sleeping. Wilson shuts out the light and goes to the living room. He settles down on the couch with a sigh of satisfaction; it’s been a good day. He falls asleep almost as quickly as House had.
CHAPTER TWO: Trust
Wilson enters the bedroom quietly. It’s 6:30am, and House is still sleeping, undisturbed by the beeping IV pump. Wilson hangs the new TPN bag and administers a dose of Zofran. As he turns to leave the room, House stirs and opens his eyes.
“Go back to sleep,” Wilson tells him. “Just hung a new bag; you’re good to go. Too early to be up.”
“You’re up. Besides, I went to bed around nine; been sleeping over nine hours. Can’t sleep much more. “And,” House brightens; “I’m up early enough to catch Blue’s Clues from the beginning! Ya miss that first clue, you’re screwed for the rest of the show. ‘Course,” he frowns thoughtfully, “hasn’t been the same since they replaced Steve with Joe. That was so cold.”
Wilson stares at him, open-mouthed. “You’re serious?”
“Always been a big supporter of educational TV. Gotta admit, though, never did get into those Teletubbies; Tinky Winky just... weirded me out.” He shudders.
Wilson considers the advisability of pursuing this conversation, and decides, firmly, against it. As a matter of fact, he’d prefer to pretend it never happened. “Umm… so, you ready to hike to the living room?”
“Yeah; that’s where the TV is,” House grins wickedly. Then his face grows serious. “And… we need to talk.”
“About what? ‘Cuz I’m really not up for an in-depth debate about SpongeBob Squarepants’ tastes in music; we covered that pretty thoroughly already. And Cuddy, by the way, was not happy about being pulled into that discussion. ”
“Can we… do this over breakfast?” House asks; he looks almost nervous.
“Sure.” Wilson’s worried about the left leg; he wants to observe House walking. “Let me disconnect the IV and get your cane, okay?”
House nods, reluctantly.
When Wilson hands him the cane, he sees House eye it almost fearfully. But House stands and makes his way out of the room without apparent difficulty, and settles himself easily on the couch in the living room.
Wilson goes into the kitchen, puzzled. He can’t imagine what House wants to talk about, but it sounds serious. He prepares eggs and toast, and carries the plates to the living room.
It’s midway through breakfast before House begins to speak. “There may be a little problem with my leg. The… left one. Sure it’s nothing.” He puts down his fork, and watches Wilson’s face carefully.
“You’re probably right, but why don’t you tell me exactly what’s been going on,” Wilson says. He keeps his voice casual, and continues to eat. He brought it up himself! Progress, real progress.
“I’ve been having some… uh… pain. Since Monday, I think. Pain feels kind’ve… familiar.”
“Like it did during the infarction?” Wilson has to force the words past the sudden fear that’s closed up his throat. It hadn’t previously occurred to him, but if House is describing thigh symptoms as 'familiar'…. Wilson puts down his fork, drops all pretense that this is just a casual conversation, and focuses his full attention on House.
“No, not like that. More like the way the right leg’s felt the last few months. Spasmodic. Clenching.” There’s a long pause. “Bad.”
Wilson is still studying House. “You’re certain it doesn’t feel like it did… then?”
House actually rolls his eyes, but it seems to Wilson that he’s too quick to dismiss the idea. “You think I’d be sitting here, calmly discussing this, if I thought it could be an infarct?” House asks him.
I really don’t know; wish I did. But since you’re actually telling me about it, well… makes it easier to believe you’re telling the truth. “How often is this happening?”
“Few times a day. Not so bad if I watch my stride.”
Ah, so that explains the controlled gait Cuddy and I’ve been seeing since Monday! “Does it happen when you’re not walking?” Silence, as House looks away. “House…” Wilson says quietly.
“Yeah. Sometimes.” House takes a deep breath and looks back at Wilson. “But it’s probably nothing. I took that fall the first night home, and again Monday night. Or all the vomiting. Either of those things could’ve caused a pulled muscle.”
Yeah, but the fall Sunday was minor, harmless. And Cuddy noticed the changes in stride before the Monday incident. And if you thought that’s what it really was, you wouldn’t be looking at me like that, almost pleading with me to agree with you. “It’s… possible,” Wilson finally says. “But we need to get it figured out. When I draw the labs this morning, I’ll get some extra blood, have ‘em run enzymes and--”
“I told you it’s not an infarct!” House interrupts angrily. Too angrily, in Wilson’s opinion.
Wilson smiles at him almost gently. “Humor me. We’re not taking any chances, that’s all. If it’s a severe muscle pull, your enzymes’ll be elevated anyway. And I’ll get us scheduled at Princeton General for some x-rays, an MRI. I think we can get it done this evening, after hours. Don’t want you to have to wait too long.”
Still protecting me, keeping it all private. Thanks, Jimmy. “You think all that’s necessary? Sounds like a lot of trouble for muscle strain.”
“Hey, you’re getting healthy, and I’m getting bored. Just let me feel like a real doctor for a little while.” Wilson smiles, but House doesn’t smile back.
“What do you think it is?” House asks quietly.
I’d tell any other patient that there’s no sense speculating and worrying until we have more information. And any other patient would buy that, because they’d want to. He’s scared right now; maybe he needs that same kind of hope. “Not gonna make myself crazy guessing. Let’s just wait until we have some concrete results. We’ll deal with it from there,” Wilson says, and the confidence in his voice pushes back a little of the fear in House’s eyes.
As Wilson stands to gather the supplies for the lab draw, he says, “I’m gonna move the labs to twice a day now, 8:00am and 8:00pm. And you’re stable enough that I feel comfortable putting the vitals and assessment on the same schedule. That okay with you?”
“Yeah. What I wanna know is when you’re gonna schedule the TPN for overnight only.” House is clearly glad of the subject change, and Wilson knows he’s looking for the diversion of an argument; he’s eyeing the extra blood tubes Wilson’s filling.
“I think once you’ve gained twenty-five pounds, we can go to night feeds.”
“Twenty-five? That’ll take too long. Fifteen,” House states firmly.
Hiding his smile, Wilson plays along. “Nope. Twenty-five. You’ve already gained six, according to that antique bathroom scale of yours. That’s only nineteen more.”
“It’d be only nine more if we were shooting for fifteen,” House says stubbornly.
“Tell ya what,” Wilson says. “Let’s split the difference. Twenty. You’re only fourteen pounds away. About a week.”
“Guess I can live with that,” House says grudgingly.
As Wilson reconnects the TPN line, he’s biting the inside of his cheek to hide the smile. Cuddy and Dick are right; the ‘precocious kid’ approach is a winner. Why couldn’t they have shared that little secret years ago? “Twenty it is,” he tells House as he bags the tubes. I actually feel like I finally have things under control with our favorite four year old.
“What about the Zofran?” House asks.
“What about it? Another couple of weeks on that. Non-negotiable.”
“Not what I meant. When can we switch it to oral? Nausea’s pretty much under control; no reason to keep getting it IV, is there?”
Wilson’s been waiting for this; it’s another victory in House’s recovery. House has not only just acknowledged the continued need for the anti-emetic, he’s also indicated a willingness to take it himself. Wilson pretends to consider House’s request. “I suppose we could try that,” he says after a moment. “You sure you’re gonna take it?”
“I said I would, didn’t I?” House sounds irritable about the issue, and Wilson thinks he may have pushed it too far.
“Okay,” Wilson says. “You’re now officially in charge of your own oral meds.” He ceremoniously hands the bottles of hydrocodone and Zofran to House, and is touched by the oddly pleased expression on House’s face. It’s such a small thing, but to House it means regaining some of the control he’s been forced to give up.
“Sure you don’t wanna count the pills before you give ‘em to me?” House asks sarcastically.
Wilson starts guiltily; he’d actually considered doing just that. He meets House’s eyes. “Are you kidding?” he asks his friend. “That’s so unnecessary. Around here, trust is the order of the day!” And he almost believes it.Chapter Three: TESTING