House and I walked to the room, where, strangely, the rest of the team wanted to meet.
Upon entering, "MRI showed a subdural hematoma," Chase immediately said, handing the images to House.
"Bleeding around his brain caused pressure inside his head, which caused the coma," explained Dr. Foreman.
House held the images up to the light, barely allowing me to see them too.
"These look like pseudo-membranes," declared House.
"Those take time to form," I said, frowning. "If it's an old injury, it wouldn't cause the coma," I added, glancing sideways at Foreman's expression.
"It's an old injury," responded Cameron, nodding. "Patient history indicates he was hit with a tire iron in 1986, brother says he was changing a tire and it slipped."
"How many times?" I asked jokingly, receiving no reaction from anyone.
"An old hematoma placed where this one is could have caused his coma," said Foreman.
"What about his liver?" asked House, ignoring Foreman.
"LFTs are slightly elevated," Cameron responded a few seconds after looking through the documents in her hands.
"Key word is 'slightly,' as in not high enough to cause the coma," commented Chase sarcastically.
"It's the subdural," said Foreman firmly. "I say we evacuate the cavity, see if he wakes up."
Foreman's diagnosis was clinically possible; an old subdural hematoma could cause a coma in a patient. The problem was that it was extremely unlikely. Chronic hematomas can cause progressive symptoms like confusion, headache, personality changes, or lethargy, but a sudden coma? Not unless there's new bleeding.
"The neurologist thinks it's his brain and wants to open up his head?" House asked the rest of the people in the room, feigning surprise. "I'm shocked, but on the other hand, you get to use the 'big boy' drill in Daddy's big red toolbox," he added, squinting a moment later as if weighing the pros and cons of the situation.
House was about to continue whatever joke he had in store to annoy Foreman, when from the patient's bed, moving his head slightly, "No drilling," said Joey, the patient, surprising us all and stopping House in his tracks.
Surprised, we all fell completely silent, staring at the patient until, "Hi," the man said weakly.
An awkward second of silence later, Dr. Foreman was the first to fully react, "Mr. Smith," he said, approaching the bed to begin a series of neurological exams.
"Call me Joe," the patient managed to say before Dr. Foreman forced one of his eyelids open to study his eye. "Can you not do that?" he added with lethargy and dryness in his throat.
Fulfilling the patient's request, Dr. Foreman finished the neurological exam, stepped back from the patient, and turned to us, looking puzzled.
"So we're clear about the no drilling?" the patient asked, clearing his throat. "Also, it only slipped once," he added a moment later, looking at me, answering my question.
"Great to know," I said with an awkward smile.
Snapping out of his initial shock, "Are you sure about the no drilling?" House asked. "It's a great way to clear your mind," he added with a small expectant smile as he raised his eyebrows suggestively.
"Oh, this is great," the patient said with a sigh, exasperated, pushing his head against his pillow. "I've got a comedian and a teenager as doctors," he added, still speaking slowly and tiredly.
"I'm actually a full-grown adult," House clarified immediately, making the patient snort.
Despite the patient's request, House urged Dr. Foreman to continue with the neurological exam.
Shortly after, with Dr. Foreman finding nothing concerning, we left the room. "Reasons he woke up from the coma, go on," House said as we walked through the hospital halls.
"He fixed himself," offered Cameron, shrugging.
Despite how her response sounded, it wasn't empty at all. Knowing why a medical situation resolved itself without specific intervention was as complicated as diagnosing the cause of the coma in the first place.
Besides, the human body is incredibly capable of handling most things on its own; it wasn't impossible to think the patient's body had somehow healed itself.
"I agree," I said, nodding at Cameron. "To know for sure we'd need to settle on a diagnosis, and for now, without the coma, we have no more symptoms," I added seriously.
"So we wait for more symptoms?" House asked, narrowing his eyes.
"Of course not," I replied immediately. "We can also run a bunch of tests blindly—after all, the feds are paying, right?" I added jokingly, but partly recalling what happened in the elevator, making House snort knowingly. "Or we wait to see if the biopsy shows anything," I added honestly answering his question.
"Why?" Chase asked incredulously. "He's clearly okay now, he can leave."
"No, I'm not releasing him," House immediately refused.
"Because the brother doesn't want you to?" Chase asked.
"I'd say that's a small part, yes," I whispered, slightly shaking my head. Being threatened by a mobster ranked high on the list of reasons to do—or not do—something.
"Or because he had an unexplained coma," House stated deadpan, glancing at me sideways. "Which sounds better?" he asked sarcastically to everyone.
"Unexplained coma," I answered without hesitation, making House nod at me with an obvious expression.
"The hematoma caused the coma, that's the diagnosis," Foreman said, adding the last part directly to me.
"It can't be chronic since there were no prior symptoms, and since there was no recent trauma either, it's definitely not acute or subacute," I said, shaking my head.
My words made Dr. Foreman close his mouth. Unlike many times in the past, this time he didn't seem offended by me offering my opinion.
"There's no other possibility. A chronic hematoma can present no symptoms until it's too late. I think we're in a window of opportunity now," Foreman countered, surprisingly speaking directly to me.
"That's a catchy diagnosis, you could dance to that," House immediately said sarcastically, earning an annoyed look from Dr. Foreman.
Sighing, exasperated by House's attitude, "I think Chase is right," Foreman declared, making the man with the cane stop, frown at Foreman just a few steps from the free clinic door. "It still should be evacuated, but it's not an immediate threat," he added calmly facing House. "Like I said, a window of opportunity," he said, glancing at me.
Narrowing his eyes at Foreman, House turned slowly with Cameron. "Cameron's my girl," he said, smiling with awkward kindness.
Without thinking for half a second, "I'd release him," Cameron said, taking House by surprise.
"Are you disagreeing with me because—" House tried to ask, but Cameron interrupted him angrily.
"I'm disagreeing because that's my medical opinion."
"Of course it is," House muttered, narrowing his eyes.
Quickly studying Cameron's body language, I remembered the reaction I had gotten from House earlier, making me focus my attention on him. House was glancing at me sideways before immediately avoiding my gaze, walking toward the clinic door.
Something definitely happened there—I could practically smell it.
"Unless I've been named as the fourth part of the 'axis of evil', invaded and occupied, this is still not a democracy," House declared arrogantly, stopping right under the clinic's door. "He's staying," he added decisively. "Send for hepatitis serologies and an autoimmune panel, we're not waiting for more symptoms," he added, looking at me with false disdain.
Saying nothing more, House turned on his heels, finally entering the clinic. The other three doctors walked away, completely defeated by the hierarchy.
"Hepatitis?" I asked, catching up to House inside the free clinic.
"Yeah, I saw a couple of very high-quality tattoos—the kind you get in prison," House explained sarcastically, not lifting his gaze from the basket full of magazines in the waiting area.
"You think he got infected from a dirty needle," I stated, nodding as I quickly considered the possibilities.
The theory made a lot of sense. It's extremely risky to contract a blood-borne disease using needles in unhygienic places, and I highly doubted the prison tattoo artist was up to date on the latest health regulations.
Picking out a couple of magazines, "Yeah, a needle... or other things," House said, raising one eyebrow suggestively.
Oh.
"That could be a problem," I murmured.
This time, it wasn't just about the era or geographic location. A mobster admitting to being a sexually active homosexual in prison was practically unthinkable.
"Why, you think his 'brothers from another mother' won't accept his sexual preferences?" House asked ironically.
"It crossed my mind for a second," I said with a blank face. "I'm pretty sure the mobster who threatened us in the elevator less than an hour ago will be totally understanding if our patient turns out to be gay," I stated sarcastically.
"Yeah, I was thinking the same thing," House said with a small, carefree smile. A moment later, he walked into the usual office.
Snorting in disagreement and without waiting much longer, I approached the reception desk, where I greeted Fryday and called the first patient of the day shortly after.
Time passed, and with it several patients. "Just remember, don't mix aspirin with beer," I said, gently patting the shoulder of the last man I attended to, an older man who was wearing pants at least two sizes too small.
"Yeah, so sorry about that," the man replied, completely avoiding eye contact and walking away with his head down, clearly embarrassed.
"Please tell me you left the window open," House said, appearing behind me a second later.
"Of course I did," I replied obviously.
The moment the patient entered the office, visibly in pain and with swelling in his abdomen, constantly releasing gas in the form of burps, House practically left immediately, leaving me alone with the human bomb.
"So how long was the fart?" House asked in a low voice, leaning in, extremely interested.
"Eighteen seconds," I replied immediately, nodding with raised eyebrows, impressed.
"I suppose that could be considered a good one," House murmured, raising his shoulders and moving his head slightly in disdain.
"What do you mean by 'good'?" I asked incredulously. "Eighteen seconds," I stated emphatically, frowning, slightly offended.
"Paul Hunn, who holds the record for the loudest fart in the world, lasted two minutes and forty-two seconds," House stated seriously, frowning. "When you compare that to eighteen seconds," he added, shaking his head, stopping strangely excited as if the mere idea of his words was nonsense, "it's like comparing the Sistine Chapel to a baby's finger paintings. You just don't do it, no matter how much you love that baby," he said firmly, pointing at me with his finger.
Still puzzled by House's intensity on the topic, "All right, I'm sorry," I raised my hands in surrender.
House took a couple of breaths, forcibly calming himself before nodding. "It's okay," he said with his eyes closed.
"Wait, how do you know so much about Paul Hunn and a fart record?" I asked, tilting my head, remembering how bizarre the situation was.
"The real question is why you didn't know?" he asked, narrowing his eyes in disappointment. "And you want to study medicine?" he added, snorting, annoyed.
"Wait a moment, if you're such a fan of the topic, why did you leave the room immediately?" I asked accusingly.
"Well, that's because I'm not a fart smeller creep," he replied in disgust, narrowing his eyes and walking away just before I could defend myself.
"I'm not a fa—" I exclaimed immediately, standing in place, stopping abruptly as I remembered I was in the middle of a fully packed waiting room. "I'm not a fart smeller creep," I continued in a low voice, forcing myself to avoid people's stares.
Walking back to the reception desk, I reached Fryday, who was waiting for me with a look of pity on her face.
"What was that?" the nurse asked. "Is everything all right?" she added, raising an eyebrow.
"Yeah, just House being House," I replied, leaning on the desk and clenching my jaw.
"I'm so sorry for that," she said, gently patting my shoulder, "but I know what can make you feel better," she added, moving a chart in front of me with her eyebrows raised suggestively.
"Yeah?" I asked, interested, immediately opening the folder. "A baby?" I said a second later, puzzled as I quickly read the basic info on the chart.
"Not just a baby. It's a baby from teenage parents," Fryday clarified, smiling broadly.
"Ok," I murmured, not entirely sure, narrowing my eyes trying to understand the nurse. "And that's supposed to make me feel better how?" I asked a moment later, giving up.
"Well, it's a reminder for you to always use protection," she stated shamelessly, raising her eyebrows seriously.
Coughing, surprised by the woman's response, "Again, that's supposed to make me feel better how?" I asked, eyes wide open.
"I don't really know," she replied, shrugging indifferently. "But it sure would make us all feel better. We're all waiting for the day you become a really important doctor who knows how to treat the rest of the staff with the respect they deserve," she added seriously. "A change is really needed."
Nodding, I snorted amused. "Don't worry, I'm going to be a doctor," I declared seriously.
"Good," she nodded firmly. "And don't get me wrong, a baby is a miracle if you have the means and time to take care of it," she declared, tilting her head.
"Yeah, I know," I said seriously, nodding. "But thanks anyway," I added, taking the chart. "I guess," I whispered as I turned to call the patient, not really convinced.
I really didn't need a reminder to use protection the day I took that step with Diane. I knew the statistics and problems of being a teenage parent, but knowing that nurses were concerned about that situation was... pretty strange.
"All right, so, Mark Johnson," I called out to the people in the waiting room, immediately noticing how a teenager, possibly a couple of years older than me, stood up with a baby in his arms.
"Yeah," the guy—Mark—said, looking at me puzzled.
"Come into the office, please. I'll be with you in a second," I said, pointing to the open door and nodding.
"Sure," he replied, still looking at me with a strange familiarity, as if he recognized me, while walking into the clinic.
Pausing a second to think if I had seen him somewhere before, I shrugged a second later, remembering nothing, and walked to where House was, leaning by the pharmacy reading one of his magazines.
"Ready to go back?" he asked without looking up from his reading material.
"There's already a patient in there," I replied, nodding.
Sighing dramatically, "All right," he said, stepping away from the wall.
"Sorry you didn't get to rest more," I said, frowning.
I really didn't know why I was seeing the next patient so quickly. Despite what House said, working at the clinic really wasn't my responsibility.
"It's okay. You're learning," he assured me with an unpleasant, because it was him, fake kindness, placing one of his hands on my shoulder.
"Come on," I said, removing his hand from my shoulder with exaggerated disgust.
Entering the office a bit ahead of House, "Okay, so what do we have he—" I was saying, but Mark, who was rocking the uncomfortable baby on his leg, interrupted me.
"I know you from somewhere."
"I go to Waffle House a lot, at least once every two weeks," I replied, shrugging, joking slightly.
"No, it's from somewhere else," Mark said, scratching his head. "Wait a moment, you're PJ Duncan. Of course, how many freshmen work in a hospital?" he exclaimed a second later, completely excited.
Since those days when all those people had come to the hospital after reading the newspaper article, not many had recognized me at the hospital—much less in the clinic. Having someone recognize me from school was slightly uncomfortable. After all, I didn't even have a high school diploma yet, let alone a medical degree to work there.
"You'd be surprised," House replied sarcastically.
Turning, impressed, "Really?" Mark asked.
Without answering Mark's question, House slowly turned his head toward me, visibly incredulous.
Taking some disinfectant from the wall dispenser, I sat in front of the teenager and the baby. "So are you a senior?" I asked, drawing Mark's attention again.
"Oh no, but my girlfriend is," he replied, oddly proud.
"Really?" I asked, genuinely surprised. Having a baby while still in high school and not dropping out was pretty statistically uncommon.
Good for her.
"Yeah," Mark replied, nodding slightly arrogantly, misunderstanding the reason behind my question for some weird thing in his mind. "Actually, you helped her a while back when she hurt her knees playing soccer."
"Melani?" I asked incredulously, remembering the time I had 'worked' in the school nurse's office.
"Oh, you remember her name, that's cool of you," Mark said, surprised.
"Yeah... so, what brings you here?" I asked, quickly changing the subject, focusing on the baby whose eyes were red from crying.
"Oh, right," Mark exclaimed, apparently just now remembering where he was and why. "This is my baby brother—" he was explaining, but I interrupted him.
"Brother? I thought he was your son," I said, reopening the form Mark had filled out upon arriving at the clinic. He had definitely put himself down as the father.
"Fuck," Mark muttered, hitting his forehead with his open palm. "I wasn't supposed to say that," he added, annoyed with himself. "I'm watching him while our parents are in Barbados," he admitted, lowering his head, disappointed.
"Okay," I murmured, crossing out that part of the form and correcting the information.
"Do you have to call my parents?" he asked nervously, opening one eye and contorting his face as if bracing for bad news.
Definitely, I had only known him for a couple of minutes, and I wasn't sure what kind of parents would leave any baby in Mark's care.
"It depends on why they're here," I replied a moment later, exhaling through my nose.
"Well, he's having trouble breathing, and there's a lot of wheezing," Mark replied, for a moment possibly trying to imitate what he was describing to me.
"Whistling," I murmured, taking the stethoscope I had previously disinfected for my use.
Upon checking the baby's airways, I could indeed hear an obstruction in his upper airways, his nose, surely an object.
"There's definitely something in his nose," I said, hanging the stethoscope around my neck.
"Oh my God, my parents are going to kill me," Mark murmured worriedly, "can you get it out?" he asked hopefully a moment later.
Taking a pair of small bayonet forceps, "I can try," I declared, "hold his head, like this," I said, showing Mark with my own head, "the baby's head," I clarified a second later when the teenager moved his own head instead of his brother's.
"Right," Mark said, slightly embarrassed, following my instruction.
Moving to begin the search, "I know, I'm sorry," I said a second before managing to grab something with the forceps, "there you go," I declared proudly, pulling out a small toy policeman, "code four," I murmured, placing the toy on the Mayo stand.
"Great," Mark said, relieved.
A moment later, House's pager went off, drawing everyone's attention in the room.
"If you're done with this, we have to go," House said, standing up a second after reading the message on his small device.
"I'll catch up in a second," I replied, quickly grabbing the stethoscope from around my neck.
I knew the message House had received was definitely an emergency with the patient, but that didn't mean I could neglect the baby in front of me.
Being such a small baby, only a few months older than Charlie, it was quite possible he had stuck more than one thing up his nose—I had seen it dozens of times working as a paramedic.
Checking his airways again, "there's still something there," I said frustrated after still hearing the obstruction—whatever he stuck up his nose first had definitely been pushed deeper by the second toy.
Searching through the drawers in the room, slightly anxious wondering what the emergency could be about, I found a flexible rhinoscope.
"This is going to be more uncomfortable, I need you to hold him by hugging him like this," I said, showing Mark how to prevent the baby from moving, holding his arms and head in something very close to a chokehold technique, "don't use too much force," I warned.
"Got it," Mark responded, nodding.
The flexible rhinoscope would only help me see how deep and complicated the obstruction in the baby's nose was. This was critical because if it was too deep or in a position that made extraction too difficult, surgery might be necessary.
Pulling the rhinoscope out of the baby's nose, "Did you play Monopoly recently?" I asked upon visualizing the obstruction—a small metal cat.
"Yeah, how did you know?" Mark asked, letting go of his brother, who immediately hit the teenager's arm.
"Just a hunch," I replied, "hold him again," I quietly ordered, focusing on remembering the toy's position.
With the baby's head immediately tilted, I carefully began the exploration.
Upon feeling the toy with the forceps, "I got—" I was saying, "fu—" I murmured as I felt it slip, "this isn't going to work," I declared, pulling the forceps out of the baby's nose, shaking my head in frustration.
The toy was too far back and covered in too much mucus to be viable for removal with forceps—I needed suction or...
"Let's see," I said, standing up as I searched for the rhinoscope. In the drawers, I had seen an electric magnet, "perfect," I murmured.
Testing the magnet's strength by attracting the forceps I had just used a second ago.
"What is that?" Mark asked nervously.
"A magnet," I replied obviously, moving quickly but carefully so as not to hurt the little boy, "this should work," I murmured, not entirely sure the Monopoly pieces were made of ferromagnetic metal.
Turning the magnet on inside the baby's nose, I almost immediately felt the small toy deep in his airway stick to the device, "got it," I said proudly, pulling a small metal cat from the nose.
Leaving the cat next to the policeman, I checked the baby's airways again—now they sounded completely clear.
"It's done, please keep an eye on him at all times," I said, quickly standing up, "I hope I don't see you here again," I added, speaking to the little boy as a joke.
Before turning around to leave the room, the two toys on the Mayo stand caught my attention for a fraction of a second. A cat and then a policeman—if it wasn't a coincidence, it was a great association of concepts.
"Thanks dude," said Mike just before I left the room.
Leaving the chart with Fryday and quickly explaining that there would be no follow-up for the case, I got ready to run—well, really walk quickly, since it wasn't safe to run in the hospital hallways—toward the patient's room. But before I could begin to move, I saw House entering with a visibly annoyed frown.
"Did he run or something?" I asked to no one in particular, checking my watch, impressed by House's speed. "What happened?" I asked as House passed close to me.
"He wasn't there," House replied, walking toward Dr. Cuddy's office.
"What?" I asked, confused, watching House's back as he walked away from me.
Turning to Fryday, who was also watching House, I shared a puzzled look for a second. "Wait," said the nurse, raising one of her fingers, picking up the phone from her desk and dialing a number. She waited a few seconds, "Hey," she greeted, smiling a moment later, "what happened with House's patient?" she asked without preamble.
I couldn't help but chuckle—I had seen the results of the nurse gossip network dozens of times, but never actually seen it in action.
"All right, thanks," Fryday finally murmured, hanging up a second later, "Vogler forced the discharge," she said, keeping her voice low while glancing cautiously toward Dr. Cuddy's office.
Why would Vogler want to discharge a patient who would definitely pay the hospital bill?
"Do you know how he found out the patient woke up from the coma?" I asked, frowning. I knew that the nurses, being on 'my side,' avoided updating Vogler on things I was involved in—the women proudly admitted it to me.
"Not a clue, at least not from any nurse," Fryday responded immediately.
Was it possible the federal agents spoke to Vogler? After all, they were present outside the room. No, it didn't make sense that the agents would want to risk their operation with an early discharge.
Before I could think of more possibilities, House, who had entered the office less than two minutes earlier, came out with a much more relaxed expression—victorious even.
"Come on," he urged me to follow him.
"See you, thanks," I said to Fryday, following House a moment later.
"What happened?" I asked, quickly catching up with House.
"He's on his way back to the ER," House replied, excited.
When we got to the emergency room, we saw the paramedics coming in with the patient on the stretcher. "Just started vomiting and passed out," said one of the federal agents, entering alongside the paramedics.
"Thirty-five-year-old male," one of the paramedics said quickly while doing his job, "vital signs are stable now, gave him two liters en route."
"He was just released from here one hour ago," said the agent next to House and me. At that moment, Vogler and Dr. Cuddy joined us, "you said he was good to go," he added accusingly, looking at Vogler.
"So, the junior G-man badge isn't looking so good," House said with a smile, triumphantly leaning toward Vogler.
Apparently, without needing to say anything else, House walked out.
Narrowing my eyes, "Nurse, can you examine the vomit?" I said, unable to fully distinguish what was on the patient's clothes.
Vogler, who was next to me with a forcibly neutral expression after hearing House's words, scoffed openly turning to face me.
"Sure, PJ," the nurse replied with a smile, interrupting whatever Vogler was about to say. "Looks like fat," she said, handling a piece of the waste.
"Fat?" I asked, puzzled.
"Yeah, like meat fat," the woman said, nodding.
"All right, thanks," I murmured, narrowing my eyes. Within the patient's entire medical history, there was also the diet enforced by the feds. The patient didn't eat anything not provided by them, and if I remembered correctly, there was never any meat in the meal plans—at least not the kind with fat chunks.
Not entirely sure how that information was connected to the case, I turned, getting ready to follow House.
"Doctor Cuddy," I said with a smile to the woman as a farewell, receiving a small smile in return.
Before long, I caught up with House and together we walked to the diagnostics lounge, where we waited a couple of minutes until the rest of the doctors arrived.
"His liver's worse," Chase said immediately upon entering.
"Comatose?" asked House.
"No, completely different symptoms than the first time," Cameron replied.
"His serology test came back positive for hepatitis C," Chase said, reading from a sheet.
"Hep C is a chronic condition," House declared condescendingly. "You don't think this is an acute situation?" he asked, narrowing his eyes.
"Coma, vomiting, abdominal pain," Dr. Chase listed. "Hep C explains everything."
"Except for the suddenness of the onset," House said pedantically.
"What's wrong with the timing?" asked Dr. Foreman.
"You get home one night, your wife hits you with a baseball bat," House narrated calmly. "Likely causes: The fact that you haven't thanked her for dinner in eight years... or the receipt for fur handcuffs that she found in your pants? Sudden onset equals approximate cause."
"He also has high estrogen levels in his blood," Chase declared, reading again from the paper. "That's indicative of a chronic condition, not acute," he added.
"One test—what do his other liver tests tell us?" House asked.
"Normal albumin levels," Cameron responded, "point toward acute."
House, hearing Cameron's words, nodded and pointed at her.
"Oh, okay, and uh why is her test better than mine?" asked Chase, offended.
"Because she's cuter," House replied, causing Cameron to lower her head slightly, "though it's close."
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I cut this chapter in half because this week I won't be able to write anything since it's final exams week.
After that, two months of school vacation!
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Author Thoughts:
As always, I'm not American, not a doctor, not a fighter, not Magnus Carlsen, not Michael Phelps, not Arsene Lupin, not McLovin and not Elliot.
Another chapter has passed, so new thanks are in order. I would like to especially thank:
11332223
RandomPasserby96
Victor_Venegas
I think that's all. As always, if you find any errors, please let me know, and I'll correct them immediately.
Thank you for reading! :D
PS: PLEASE LEAVE A REVIEW.