Post-Trauma 3.2/?
A little continuation of last night's "Post-Trauma" installment.
A/N: Yes, I know it's hard to read without spaces in between the paragraphs. If there's a way to put them in other than entering them all manually, I'm willing to hear it. I write a lot of things that need to be in manuscript format (no spaces between paragraphs), and getting into the habit of doing it "wrong" is not a risk I'm willing to take. (I don't write "C U L8R" in AIM either, for the same reason.)
“House…you have, had, a drug problem. That doesn’t mean everything about you is bad,” James says.
“I know,” Greg says seriously. “There’s plenty of other reasons.”
Before Temas can ask for examples, James answers, “Come on. Sure, you’re kind of an asshole, but that’s part of your charm.”
“I’ve changed,” Greg says flatly.
“I know. I just don’t think it’s an improvement.”
“I’m better now,” Greg answers. “I have to be better.”
He concentrates on his Lego building for several minutes. James looks over his head and asks Temas, “We have to fix this.”
“We can’t,” Temas answers. “It’s Greg’s job to--” he normally says “get better,” but that seems to be a loaded word “-fix this. All we can do is support him.”
“I’m fine,” Greg interjects.
“Greg, how do you feel about what James has said today?”
“I don’t know.”
“You seem upset.”
“I’m not upset. I’m fine.”
After a few minutes of watching Greg build, James eases off of his chair and onto the floor, and reaches for the Lego tub. He starts making what looks like a skyscraper. “Have you been out on your bike lately?” he asks casually.
“I sold it. You were right-not a good combination with a crippled, irresponsible drug addict.”
James winces. “What did you get?”
“Subaru.”
“…Cool.”
Shrug.
They build some more. Temas decides not to interrupt.
“Empire State Building?” Greg asks after a while.
“Yeah.”
Greg gets to his feet, with some difficulty, and goes over to the toy shelves, returning a moment later. He hands James a plastic gorilla that Temas recognizes from the zoo playset.
“Kong?” James asks.
“Yeah.”
“Thanks.”
Now Temas tries not to look like he’s paying as much attention as he is. The movie is all about how those who don’t fit in are destroyed by an increasingly homogeneous modern society-Greg can’t have chosen it by accident.
“Do you want to do the planes?” James asks.
“Nah.”
James puts Kong on top the building. “How’s the catapult?”
“Looks more like a trebuchet. But okay.”
“We’ve only got a few more minutes, guys,” Temas says. “Anything else you want to talk about?”
Greg starts taking apart his catapult. “Yes. Can I still see Wilson?”
“You don’t need my permission,” Temas answers.
“I don’t want to get in any trouble.”
“I think you’ll be okay. Thanks for coming, James.”
“You’re welcome.”
“Any progress on the lab tests?” Temas asks.
James looks over at Greg, like he’s not sure they should be talking about it in front of him. “Yes, actually. We found some traces of what looks like Ritalin, and some other things we haven’t identified yet.”
“Ritalin?”
“That’s can’t be true,” Greg says anxiously. “I don’t use stimulants. I never have.”
“I know,” Temas answers. “We’re trying to figure out what Dr. Luerssen was injecting you with, remember?”
Greg settles down and points out, “I don’t have ADHD.”
“I know.”
“It might not have been Ritalin, exactly,” James says. “There were only minute traces. It could have been something similar. We’re going to check the hair samples next, try to pin it down.”
“Okay. Keep us posted.”
“Sure.”
As he turns to go, James pauses. “I’ve been meaning to ask you.”
“Yes?”
“Do you have any experience working with terminally ill children?”
“Some. I haven’t made a specialty of it-too depressing, even for me.”
“I have a patient whose…well, most of them are terminally ill. But she’s eight, and her parents are not dealing with it well, and she’s…well, I’d like her to see someone.”
“I’d be happy to see her for an intake appointment, and make a referral if I don’t think I can help her.”
“Thanks. I’ll be in touch.”
That was weird, Wilson thinks as he and House walk out to his car. “Dr. Temas seems nice,” he says instead.
“You really think I’m not better?” House says in a defeated tone.
“I don’t know, House.”
“I have to be better. If he thinks I’m not better, I’ll have to go back to rehab.”
“I don’t think that’s how it works,” Wilson says cautiously.
“That’s what they said.”
“I think you only have to go back if you start using drugs again.”
“That’s not what they said. I don’t want to go back. Tell him I’m better,” House begs.
“He’s not going to send you back because I don’t think you’re happy,” Wilson tries to assure him.
“He might. Tell him. I really am better.”
Wilson hesitates. “Okay. C’mon.” He turns to go back into the building. House hurries after him. Inside, it takes a few minutes for the receptionist to determine that Dr. Temas is able to see them for a few more minutes.
Temas is straightening his toy shelves. “What do you need?”
“Is it true that House has to go back to rehab if he’s not better?” Wilson ignores House’s whimper of betrayal.
“No, that’s not how it works. Greg was court-ordered into, what was it, sixty days of rehab?”
“Ninety,” Greg supplies.
“Right. And six months of weekly sessions for follow-up and monitoring, which will be finished in a month. It would take a new court order to compel you to return to residential treatment-or to force you to keep coming to sessions after next month, although I hope you’ll keep coming voluntarily.”
Wilson turned to House. “See?”
“He has to say that,” House mutters.
“I do have to say it, because it’s true,” Temas says. “I don’t have the power to make you go back to rehab even if I wanted to, which I don’t. The only way I’d seek a court order to send you back to rehab, or stand a chance of getting one, is if you were habitually using drugs again, and I know you’re not. I can’t send you back to rehab for disagreeing with me or for being unhappy, or for having friends I don’t approve of. As long as you’re not using narcotics, you’re fine. And even if you started having trouble staying clean, we’d try to work on it here first.”
“That’s what I thought,” Wilson says. “See?”
“Yes,” House says flatly. “Thank you.”
“I wish you’d said something earlier,” Temas adds. “Is there anything else you’ve been worried about?”
“No,” House answers dully.
“We can talk about this more next time. Do you still have your copy of the court order? There should be one in your file that I can show you.”
“I believe you.”
Wilson doesn’t think Temas believes him, either, but he says, “Okay. I’m sorry we can’t talk more about this now, but I have another patient coming in. I’ll see you next week.”
House follows him out silently. After they’ve gotten in the car, he says, “You lied to me.”
“Sorry. I thought you’d feel better once you heard from him that he wasn’t going to send you back.”
“He’ll just tell them that I started using again. If he decides to send me back.”
“He’d need some kind of proof,” Wilson points out. “Positive drug tests, something.”
House shakes his head.
“Do you want to come back to my place? Get some Chinese?”
“I have to go back to work.”
“…Right. I meant after we go back to work for an hour, obviously.”
When they get back to the hospital, House’s team is whiteboarding a case. “We should do a spinal tap to rule out MS,” Chase says.
“Could still be autoimmune,” Cameron puts in. “Hi, House.”
“Those all sound like great ideas,” he answers with a rictus-like smile. “Keep going.” Normal people are Supportive and Encouraging. He sits at the table with the others, but he can’t concentrate on what they’re saying. He just nods and agrees whenever anyone looks at him.
He really isn’t any smarter than anyone else. Thinking he is was part of his problem. Any reasonably competent doctor could do what he does, and his staff as reasonably competent.
“Okay, then. Foreman is getting the blood and CSF samples, Chase is hitting the books, and I’ll be in the lab,” Cameron sums up. “All right, House?”
“That sounds great,” House agrees.
“Are there any other tests you want us to run?” Chase asks.
“It sounds like you have it covered.”
The team drifted away, and House retreats into his office where his paperwork awaited.
Temas presses a hand over his eyes. “How would you handle the issues specific to an individual who has a chronic pain problem as well as addiction?”
“Many studies have established that individuals with a genuine pain problem do not become addicted to their pain medication,” the person on the other end of the phone said, in a condescending tone. “If a patient is addicted, that means that they aren’t in pain.”
“So if an addicted patient believes that he or she is in pain…?”
“They’re lying.”
“I see,” Temas says curtly.
“If that’s all…”
“No, I have some more questions.” Temas is holding on to his temper with both hands. He’d just as soon hang up before he says something he’ll regret, but he has more than one patient to think of. If he hangs up now, he’ll just have to call back. “What about the relationship between sexual abuse or incest and addiction issues?” Tom L. and Marta J. both have abuse histories, as well as Isabelle D.
“You can’t believe anything an addict says about their past. That’s why here we focus on behavior, not excuses.”
“So you don’t attempt to work on underlying issues that drove the patient to use drugs in the first place,” Temas paraphrases.
“Addicts aren’t driven to use drugs; they choose to use.”
“You’re not concerned that if the underlying issues aren’t addressed, the patient might turn to another form of problem behavior after overcoming addiction?”
“We address that possibility by addressing the addicts’ behavior globally, rather than focusing only on avoiding drug use.”
“Last question. Do you use any kind of medication during treatment?”
“No. We teach addicts to rely on the program, not chemicals.”
“Great,” Temas says flatly. “Thanks for your time.”
“You’re welcome. You should call back soon if you want to send in patients-we only have so many slots.”
“I’ll keep that in mind.” He drops the phone on his desk. “Damn those fucking sonofabitches to fucking hell.”
“But how do you really feel?” Lee asks, appearing in the doorway.
Temas sighs. “You know how most of that sadistic prick’s patients were referred to him from residential treatment?”
“Yeah.” Lee sits down on the edge of his desk.
“Turns out nearly all of them came from treatment facilities run by the same group.”
“That’s weird.”
“Yeah. I’m starting to think Luerssen didn’t screw his victims up all on his own. Something one them said in session led me to check into it. Get this-95% of their adult patients are court-ordered.”
“So they can’t get anyone to stay who has a choice,” Lee observes.
“Exactly. They seem to be adopting the therapeutic model that’s turned treating troubled teens into a million-dollar death machine. I’ve got a patient they kept in an isolation room for forty-seven days straight.”
“Should you be telling me this?”
“I’m not telling you which one. Then he was out for four days and back in for another thirteen. One of the other facilities had patients restraining other patients-and they actually charted it. Maybe they were all doing it. Another patient disclosed incest, and they called her a liar and made her wear a sign that said, “Daddy’s little whore.’ They charted that, too. I don’t even want to think about what they were doing that they didn’t put on the patients’ charts.”
“Injecting them with secret mind-control drugs?” Lee suggests lightly. He doesn’t entirely believe Temas’s suspicions about Luerssen.
“Maybe,” Temas answers. “Luerssen was injecting them with something. You know that radical schizophrenic group?”
“The ones who think the entire psychotherapeutic complex is a vast mind-control conspiracy? Yeah.”
“The more I look into this, the more it looks like they might be on to something. Not really, but half of these patients were measurably better off before they started treatment.”
“What are you going to do?” Lee asks.
Temas shrugs. “Write a letter to the APA? If I can figure out what to say without sounding like a paranoid.”
A/N: Yes, I know it's hard to read without spaces in between the paragraphs. If there's a way to put them in other than entering them all manually, I'm willing to hear it. I write a lot of things that need to be in manuscript format (no spaces between paragraphs), and getting into the habit of doing it "wrong" is not a risk I'm willing to take. (I don't write "C U L8R" in AIM either, for the same reason.)
“House…you have, had, a drug problem. That doesn’t mean everything about you is bad,” James says.
“I know,” Greg says seriously. “There’s plenty of other reasons.”
Before Temas can ask for examples, James answers, “Come on. Sure, you’re kind of an asshole, but that’s part of your charm.”
“I’ve changed,” Greg says flatly.
“I know. I just don’t think it’s an improvement.”
“I’m better now,” Greg answers. “I have to be better.”
He concentrates on his Lego building for several minutes. James looks over his head and asks Temas, “We have to fix this.”
“We can’t,” Temas answers. “It’s Greg’s job to--” he normally says “get better,” but that seems to be a loaded word “-fix this. All we can do is support him.”
“I’m fine,” Greg interjects.
“Greg, how do you feel about what James has said today?”
“I don’t know.”
“You seem upset.”
“I’m not upset. I’m fine.”
After a few minutes of watching Greg build, James eases off of his chair and onto the floor, and reaches for the Lego tub. He starts making what looks like a skyscraper. “Have you been out on your bike lately?” he asks casually.
“I sold it. You were right-not a good combination with a crippled, irresponsible drug addict.”
James winces. “What did you get?”
“Subaru.”
“…Cool.”
Shrug.
They build some more. Temas decides not to interrupt.
“Empire State Building?” Greg asks after a while.
“Yeah.”
Greg gets to his feet, with some difficulty, and goes over to the toy shelves, returning a moment later. He hands James a plastic gorilla that Temas recognizes from the zoo playset.
“Kong?” James asks.
“Yeah.”
“Thanks.”
Now Temas tries not to look like he’s paying as much attention as he is. The movie is all about how those who don’t fit in are destroyed by an increasingly homogeneous modern society-Greg can’t have chosen it by accident.
“Do you want to do the planes?” James asks.
“Nah.”
James puts Kong on top the building. “How’s the catapult?”
“Looks more like a trebuchet. But okay.”
“We’ve only got a few more minutes, guys,” Temas says. “Anything else you want to talk about?”
Greg starts taking apart his catapult. “Yes. Can I still see Wilson?”
“You don’t need my permission,” Temas answers.
“I don’t want to get in any trouble.”
“I think you’ll be okay. Thanks for coming, James.”
“You’re welcome.”
“Any progress on the lab tests?” Temas asks.
James looks over at Greg, like he’s not sure they should be talking about it in front of him. “Yes, actually. We found some traces of what looks like Ritalin, and some other things we haven’t identified yet.”
“Ritalin?”
“That’s can’t be true,” Greg says anxiously. “I don’t use stimulants. I never have.”
“I know,” Temas answers. “We’re trying to figure out what Dr. Luerssen was injecting you with, remember?”
Greg settles down and points out, “I don’t have ADHD.”
“I know.”
“It might not have been Ritalin, exactly,” James says. “There were only minute traces. It could have been something similar. We’re going to check the hair samples next, try to pin it down.”
“Okay. Keep us posted.”
“Sure.”
As he turns to go, James pauses. “I’ve been meaning to ask you.”
“Yes?”
“Do you have any experience working with terminally ill children?”
“Some. I haven’t made a specialty of it-too depressing, even for me.”
“I have a patient whose…well, most of them are terminally ill. But she’s eight, and her parents are not dealing with it well, and she’s…well, I’d like her to see someone.”
“I’d be happy to see her for an intake appointment, and make a referral if I don’t think I can help her.”
“Thanks. I’ll be in touch.”
That was weird, Wilson thinks as he and House walk out to his car. “Dr. Temas seems nice,” he says instead.
“You really think I’m not better?” House says in a defeated tone.
“I don’t know, House.”
“I have to be better. If he thinks I’m not better, I’ll have to go back to rehab.”
“I don’t think that’s how it works,” Wilson says cautiously.
“That’s what they said.”
“I think you only have to go back if you start using drugs again.”
“That’s not what they said. I don’t want to go back. Tell him I’m better,” House begs.
“He’s not going to send you back because I don’t think you’re happy,” Wilson tries to assure him.
“He might. Tell him. I really am better.”
Wilson hesitates. “Okay. C’mon.” He turns to go back into the building. House hurries after him. Inside, it takes a few minutes for the receptionist to determine that Dr. Temas is able to see them for a few more minutes.
Temas is straightening his toy shelves. “What do you need?”
“Is it true that House has to go back to rehab if he’s not better?” Wilson ignores House’s whimper of betrayal.
“No, that’s not how it works. Greg was court-ordered into, what was it, sixty days of rehab?”
“Ninety,” Greg supplies.
“Right. And six months of weekly sessions for follow-up and monitoring, which will be finished in a month. It would take a new court order to compel you to return to residential treatment-or to force you to keep coming to sessions after next month, although I hope you’ll keep coming voluntarily.”
Wilson turned to House. “See?”
“He has to say that,” House mutters.
“I do have to say it, because it’s true,” Temas says. “I don’t have the power to make you go back to rehab even if I wanted to, which I don’t. The only way I’d seek a court order to send you back to rehab, or stand a chance of getting one, is if you were habitually using drugs again, and I know you’re not. I can’t send you back to rehab for disagreeing with me or for being unhappy, or for having friends I don’t approve of. As long as you’re not using narcotics, you’re fine. And even if you started having trouble staying clean, we’d try to work on it here first.”
“That’s what I thought,” Wilson says. “See?”
“Yes,” House says flatly. “Thank you.”
“I wish you’d said something earlier,” Temas adds. “Is there anything else you’ve been worried about?”
“No,” House answers dully.
“We can talk about this more next time. Do you still have your copy of the court order? There should be one in your file that I can show you.”
“I believe you.”
Wilson doesn’t think Temas believes him, either, but he says, “Okay. I’m sorry we can’t talk more about this now, but I have another patient coming in. I’ll see you next week.”
House follows him out silently. After they’ve gotten in the car, he says, “You lied to me.”
“Sorry. I thought you’d feel better once you heard from him that he wasn’t going to send you back.”
“He’ll just tell them that I started using again. If he decides to send me back.”
“He’d need some kind of proof,” Wilson points out. “Positive drug tests, something.”
House shakes his head.
“Do you want to come back to my place? Get some Chinese?”
“I have to go back to work.”
“…Right. I meant after we go back to work for an hour, obviously.”
When they get back to the hospital, House’s team is whiteboarding a case. “We should do a spinal tap to rule out MS,” Chase says.
“Could still be autoimmune,” Cameron puts in. “Hi, House.”
“Those all sound like great ideas,” he answers with a rictus-like smile. “Keep going.” Normal people are Supportive and Encouraging. He sits at the table with the others, but he can’t concentrate on what they’re saying. He just nods and agrees whenever anyone looks at him.
He really isn’t any smarter than anyone else. Thinking he is was part of his problem. Any reasonably competent doctor could do what he does, and his staff as reasonably competent.
“Okay, then. Foreman is getting the blood and CSF samples, Chase is hitting the books, and I’ll be in the lab,” Cameron sums up. “All right, House?”
“That sounds great,” House agrees.
“Are there any other tests you want us to run?” Chase asks.
“It sounds like you have it covered.”
The team drifted away, and House retreats into his office where his paperwork awaited.
Temas presses a hand over his eyes. “How would you handle the issues specific to an individual who has a chronic pain problem as well as addiction?”
“Many studies have established that individuals with a genuine pain problem do not become addicted to their pain medication,” the person on the other end of the phone said, in a condescending tone. “If a patient is addicted, that means that they aren’t in pain.”
“So if an addicted patient believes that he or she is in pain…?”
“They’re lying.”
“I see,” Temas says curtly.
“If that’s all…”
“No, I have some more questions.” Temas is holding on to his temper with both hands. He’d just as soon hang up before he says something he’ll regret, but he has more than one patient to think of. If he hangs up now, he’ll just have to call back. “What about the relationship between sexual abuse or incest and addiction issues?” Tom L. and Marta J. both have abuse histories, as well as Isabelle D.
“You can’t believe anything an addict says about their past. That’s why here we focus on behavior, not excuses.”
“So you don’t attempt to work on underlying issues that drove the patient to use drugs in the first place,” Temas paraphrases.
“Addicts aren’t driven to use drugs; they choose to use.”
“You’re not concerned that if the underlying issues aren’t addressed, the patient might turn to another form of problem behavior after overcoming addiction?”
“We address that possibility by addressing the addicts’ behavior globally, rather than focusing only on avoiding drug use.”
“Last question. Do you use any kind of medication during treatment?”
“No. We teach addicts to rely on the program, not chemicals.”
“Great,” Temas says flatly. “Thanks for your time.”
“You’re welcome. You should call back soon if you want to send in patients-we only have so many slots.”
“I’ll keep that in mind.” He drops the phone on his desk. “Damn those fucking sonofabitches to fucking hell.”
“But how do you really feel?” Lee asks, appearing in the doorway.
Temas sighs. “You know how most of that sadistic prick’s patients were referred to him from residential treatment?”
“Yeah.” Lee sits down on the edge of his desk.
“Turns out nearly all of them came from treatment facilities run by the same group.”
“That’s weird.”
“Yeah. I’m starting to think Luerssen didn’t screw his victims up all on his own. Something one them said in session led me to check into it. Get this-95% of their adult patients are court-ordered.”
“So they can’t get anyone to stay who has a choice,” Lee observes.
“Exactly. They seem to be adopting the therapeutic model that’s turned treating troubled teens into a million-dollar death machine. I’ve got a patient they kept in an isolation room for forty-seven days straight.”
“Should you be telling me this?”
“I’m not telling you which one. Then he was out for four days and back in for another thirteen. One of the other facilities had patients restraining other patients-and they actually charted it. Maybe they were all doing it. Another patient disclosed incest, and they called her a liar and made her wear a sign that said, “Daddy’s little whore.’ They charted that, too. I don’t even want to think about what they were doing that they didn’t put on the patients’ charts.”
“Injecting them with secret mind-control drugs?” Lee suggests lightly. He doesn’t entirely believe Temas’s suspicions about Luerssen.
“Maybe,” Temas answers. “Luerssen was injecting them with something. You know that radical schizophrenic group?”
“The ones who think the entire psychotherapeutic complex is a vast mind-control conspiracy? Yeah.”
“The more I look into this, the more it looks like they might be on to something. Not really, but half of these patients were measurably better off before they started treatment.”
“What are you going to do?” Lee asks.
Temas shrugs. “Write a letter to the APA? If I can figure out what to say without sounding like a paranoid.”