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House stayed late at the hospital that evening, moodily bouncing his ball and surfing the internet in his office, and every so often erupting into the conference room to glare at the baffling list of symptoms scrawled on the whiteboard and at whichever fellows had the misfortune to be present. Although their patient’s condition didn’t appear to be life-threatening for the time being, no one dared to leave as long as House seemed concerned enough about the case to stick around. Even Chase abandoned the idea of an evening out and made a few hasty phone calls to cancel his social obligations.

Around nine p.m., Cuddy came around to scold House into eating a sandwich she’d brought, and he ended up leaving with her, limping more heavily than usual, and pointing his cane at the Cottages in an unspoken but unmistakable threat as he departed.

Back at his apartment, House was obviously distracted. When Cuddy pushed him up against the nearest wall and kissed him, he responded automatically, but his mind was elsewhere. “Earth to House,” she hissed finally in exasperation.

His eyes snapped back into focus. “This was a mistake,” he said.

“House, I know you can’t help… being you, but try to let it go. Dr. Brennan isn’t in any immediate danger. You’ll figure this out. I have complete faith in you.”

“Even my brain needs blood to work, and you seem intent on redirecting it.”

“Only temporarily,” Cuddy murmured, nuzzling his neck and sliding a hand to the small of his back. “Surely you can spare a few minutes.”

“That’s what she said,” House leered. “Oh, wait.”

***

More than a few minutes later, they lay side by side on top of the covers, listening to each other’s breaths slow. “I’d better go,” Cuddy sighed. “I’ll see you in the morning.”

“Stay,” House implored, but she shook her head.

“I have a seven-thirty meeting with a big donor.”

“How about if you postpone it until after your nine o’clock meeting with a big boner?”

“You’re impossible,” Cuddy scolded.

“No, just highly improbable.”

“I’ll expect to see you in the clinic by eight-thirty. You owe me hours for last week, too.”

“I thought my lackeys covered for me last week.”

Cuddy scoffed as she bent to pick up her skirt. “Don’t think that you can get out of clinic duty just because you’re boffing the boss.”

***

“Dr. Cuddy? Camille Saroyan, I head the Forensic Division at the Jeffersonian.”

Cuddy got up from behind her desk to shake hands. “You must be here to see Dr. Brennan.”

“I meant to come earlier in the week, but my daughter was freaking out over the SATs, and I couldn’t get away.”

“You don’t look like you could possibly have a daughter that old,” Cuddy commented. “I don’t know how you managed it with residency and all. I can afford full time help now, and I still never seem to have time for anything.”

“I adopted Michelle when she was already a teenager,” Cam explained.

“Really? Rachel’s my foster daughter,” Cuddy smiled, showing off her favorite photo.

“Cute,” Cam said dutifully. “So how’s Dr. Brennan doing?”

“Well, as you probably know, we had expected to release her yesterday, but she developed some new neurological symptoms. But I’m very hopeful. Our entire department of Diagnostics is dedicated to her case.”

“As the Dean of Medicine, do you have time to keep so well-informed about all of your patients, or just the famous ones?” Cam asked drily.

“Let’s just say that the department head and I are very close.”

“Really?” Cam replied, amused, and deliberately declined to follow up the first thought that came to mind. “Does he call you in on consults?”

“Not exactly,” Cuddy admitted. “I was trained as an endocrinologist, but my main role here is administrative. Dr. House likes to say that’s in everyone’s best interests.”

“I’ll do you one better,” Cam confided. “I was told that I would only get my medical degree if I promised to practice exclusively on dead people.”

Cuddy stared at the other woman for a moment before Cam broke into a brilliant smile. “Had you there, didn’t I?”

Pushing her hair aside with a rueful expression, Cuddy shrugged. “I do know a number of doctors who might have benefited from that restriction.”

***

Cold, cold, UTI, cold, UTI. House wondered, not for the first time, whether they would haul him out of the clinic in a straitjacket one day after the tedium had literally driven him insane. Again.

His sixth patient pulled out an angry red penis and waved it around. Thanking the gods he didn’t believe in for this unexpected break in his routine, House snapped on a pair of gloves to take a closer look at the raw, blistering skin. “How long has it been like this?”

“About half an hour? I came straight here. Jesus, doc, can you do something? It itches like crazy.”

“Is this the first time you’ve experienced this condition?”

“Yeah. No. Mighta happened before, but it was never this bad.”

“O-kay. Any… unusual activities recently that I should be aware of?”

“Well,” and the man looked even more uncomfortable, if such a thing was possible, “I, uh, I had sex.”

Duuuhhhh. “And that was roughly…” House raised his eyebrows in encouragement.

“Naw, doc.” The patient sounded offended. “No rough stuff. I’m not some kind of perv or anything.”

House sighed. “I meant, roughly how long has it been? Since you had sex,” he added, to head off any more potential misunderstandings.

“Last night,” the man grunted, clenching his fists against the desperate urge to scratch.

“You have a latex allergy,” House said, pulling his gloves off hurriedly and tossing them in the trash. “But you’re in luck. There are lots of polyurethane options out there these days.”

“You mean this was caused by my condom?” the patient said incredulously.

“It’s not that uncommon. What can I say, sometimes you do everything you can to keep yourself safe, and it just ends up coming around to bite you in the…” House paused, staring off into space. “I’m an idiot.”

“Doc? Doc, you okay?” the patient called after him as he hightailed it back to Diagnostics.

***

“Our patient didn’t come down with malaria in the Maluku Islands,” House announced, stumping into the conference room where his fellows were waiting.

“Ooo…kay,” Foreman said, looking unimpressed even for him. “Our patient didn’t come down with a lot of other things, either.”

“Yes, but in this case, it was how she didn’t contract the disease that was important,” House replied, rapping his cane on the floor for added emphasis. “Anti-malarial meds.”

“Isn’t doxycycline the approved prophylactic for malaria?” Masters asked. “That doesn’t have neurological side effects.”

Foreman suddenly sat up and said, “True, but the drug it replaced, mefloquine, a.k.a. Lariam, does. Seizures, paranoid delusions, and hallucinations have all been reported in a small percentage of subjects.”

Chase had caught on by now as well. “The Surgeon General only issued the directive to switch to doxycycline last year. Dr. Brennan has been traveling to countries with endemic malaria for over a decade,” he reminded his colleagues. “She probably didn’t even bother to get a new prescription for this trip, just took what was left over from her previous supply.”

“If she’d never had any side effects before, she probably didn’t see any reason to be concerned,” Taub reflected.

“But seven months is a long time to be on that stuff. She finally accumulated high enough levels in her brain to cause the neurological symptoms we’ve observed,” Foreman concluded.

“Why would Dr. Brennan only start experiencing side effects from the drug after she came back?” Masters asked.

“Mefloquine has a half life of 10 to 40 days,” Foreman answered, “and it’s actually not uncommon for patients to develop these symptoms only after completing their course of prophylaxis.”

Masters mulled this over. “But what about the GI symptoms and fever?” she asked finally.

“Common side effects of mefloquine include nausea, abdominal distress, headache, and fever,” Foreman replied. “It all fits.”

“Hey,” Chase put in proudly, “I called the drugs.”

“It was stupid when you said it yesterday,” House shrugged. The smug smile faded from Chase’s face.

“So what’s the treatment?” Masters asked.

House and Foreman exchanged glances. “There isn’t one,” Foreman admitted. “We just have to keep her safe and stable until the drug clears out of her system. Cognitive-behavioral therapy might help, but full recovery could take weeks or even months.”

“Okay. Let me just make sure that I have this straight. All of our previous diagnoses were wrong, everything we’ve done probably just made her symptoms worse, and now that we’re nearly certain we know what’s going on, we can’t do anything about it.”

The four men avoided each other’s eyes, looking uniformly uncomfortable. “Some days are better than others,” Chase offered at last.

Read Chapter Six: More Than It Is

 

Comments

( 2 comments — Leave a comment )
jiraiyasgirl
Nov. 8th, 2010 09:18 am (UTC)
Poor Master...she's like a lamb in the lion's den some days.
flywoman
Nov. 8th, 2010 12:37 pm (UTC)
Indeed! I hope that when I finally get to see 7X6, I don't feel like my portrayal of her has been completely blown out of the water...
( 2 comments — Leave a comment )

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