"I Screwed Up A Diagnosis"
Title: ‘I Screwed Up A Diagnosis’
Author: rslworks
Prompt: #16 When Wilson misdiagnosed a man who had cancer in the Episode “Games” 4-09, and the patient was upset because he was going to live - what if the man reacted more violently than he did, and House wasn’t in the room until Wilson already got hurt?
Pairing: none
Category: hurt/comfort
Ratings/Warnings: PG-13
Words: 3732
Summary: “I would’ve thought the living mattered more than the expenses??”
Disclaimer: Don’t own ‘em, or I’d be really happy. In the meantime, thank you David Shore.
(Beta:) none
Author’s notes: There is some dialogue used verbatim from this episode so that anyone can understand my storyline whether they’ve seen “Games” or not.
When Gregory House feels the familiar, yet overwhelming urge to mess with his best buddy James Wilson, he rarely hesitates to act on it. So on this particular morning he merrily limped down the hall, flung open Wilson’s door and looked at his empty chair, perplexed. When it occurred to him to look in the chair behind the door, he found Wilson sitting, staring, with a quizzical look on his face. So he waited.
“I screwed up a diagnosis,” Wilson offered, still deep in thought.
House considered this a moment, and made his way to Wilson’s comfy desk chair.
“You don’t seem that upset about it,” he commented.
Wilson realized this was true and proceeded to explain the case to House. He had diagnosed a 55 year old patient by the name of Martin McKenna with adenocarcinoma three months prior. He’d given McKenna six months to live. Since that time, however, the patient failed to get worse. After the last recheck he decided to repeat all his tests. It was then he realized the lung biopsy was a false positive. The lesions seen on Mr. McKenna’s lungs were actually caused by talc inhalation and were benign. Turns out McKenna had changed jobs so many times in the last 15 years he had neglected to mention a year spent in a paint factory where talc exposure was routine.
“Interesting,” was House’s reply.
This led to a spontaneous argument between them as to why House couldn’t just be happy the man didn’t actually have cancer, and consequently House was no longer interested, and left Wilson’s office in a huff.
The next day Wilson was meeting with Mr. McKenna at 10:30 am and had everything he wanted to say planned out in his head. There was nothing to worry about. After all, this was good news!
At 10:32 am House hurried down the hall to Wilson’s office. It had taken him longer than anticipated to locate a lab coat anywhere on the fourth floor that fit him, and he just had to see for himself how Wilson’s patient was going to take the miraculous news of his ‘revised diagnosis.’
He burst into the oncologist’s office in time to hear Wilson say,
“I got your new test results back.”
“Sorry I’m late,” he interjected, hurrying to a spot behind Wilson.
The patient spoke up. “Who’s your colleague?”
Wilson had no choice but to answer the question. “Dr. House,”
“Yes, Dr. Wilson?”
“I really don’t need the consult.”
To which McKenna added sadly, “I know the prognosis.”
“Apparently not,” House teased.
Wilson began to explain. “Mr. McKenna, I can’t believe I’m able to say this, but…you’re cancer free. The biopsy looked like adenocarcinoma, but it wasn’t…Harmless lesions on your lungs. You’re fine!” A nervous laugh escaped him as he waited for a response.
McKenna looked back and forth from Wilson to House, totally lost. “I don’t get it.”
“Cool!” House quipped.
Wilson immediately raised a hand to stop House and looked at Mr. McKenna.
“No, it’s…it’s...I know this must come as a shock. I’ve double-checked the labs--”
“I just accepted an offer on my house. I’ve had three goodbye parties. I’m buying plane tickets to Venice,” McKenna interrupted, trying desperately to grasp the news.
“You can still use those if you’re alive,” House chimed in.
He was ignored. “I have to pay a $6,000.00 broker commission on a house I’m not selling. Money…I don’t have.”
Finally, he gave Wilson a withering look and rose to leave. “Thank you, for letting me know.”
Poor Wilson was left utterly confounded. “I…I would have thought the living would have meant more than the expenses,” he spluttered.
* * *
That night James tried to let the McKenna screw up rest, but the man’s words kept replaying in his head. He couldn’t help it. He felt responsible. And once Wilson felt responsible, things needed to be fixed. At last, he fell into fitful sleep thinking, ‘I’ll find a way.’
Thursday morning he got to his office early, armed with his personal chequebook and a blank liability release form from Legal. He would compensate Mr. McKenna for the money he needed to pay the brokerage fee and they would both feel better. He couldn’t wait for his administrative assistant Catharine to get in to carry out his plan. At 9:01 am he buzzed her.
“Catharine, I have a little job that’s a priority this morning; oh, good morning by the way. How are you, today? Sorry! Anyway, I have a liability form I need you to fill out and we’ll be sending an envelope by cab to a patient’s home address. Can you run up here and get it please? Thanks!”
With this settled in his mind, he was able to put it behind him and move on to some actual medicine. By late afternoon Wilson pushed his mouse aside and rubbed his dry, tired eyes with the heels of his hands. ‘That’s more than enough for one day,’ he thought, sighing. When he removed his hands, he realized he’d pressed too hard and his vision swam blurrily as he tried to focus on his desk clock.
Suddenly he heard his door burst open and was about to make another useless complaint to House about his privacy when he realized the blurred image that was slamming the door shut was too short and burly for House. A few more blinks and his eyes cleared.
“Mr. McKenna? We didn’t have an appointment today.”
“You ruined my life!” he hissed. His eyes were bloodshot and Wilson could smell booze wafting his way. He tensed, feeling instantly trapped behind his desk.
“Look, Mr. McKenna, I know you’re making a big readjustment here--”
“Don’t try to tell me! You don’t know anything about it! You don’t know anything about what you’ve done at all!!” McKenna was clearly distraught, waving his arms and screaming down upon Wilson where he sat. James realized it was going to be hard to keep an angry drunk rational, and his brain was whirling behind his calm brown eyes. He licked his lips and spoke quietly.
“Then tell me. Maybe I can help,” he suggested.
McKenna huffed harshly. “Yeah, right! Like you thought a measly six thousand dollars would help! I can’t even sue your ass because now this lawyer tells me there’s been no injury! No injury?” He laughed bitterly again. “I’m ruined - and now there’s no way out!”
Wilson struggled to understand the drama. “But, how can --”
McKenna pounded the desk, making Wilson jump despite himself. “I thought I was dying! I bought things! A lot of things, okay! Things for me, and my wife and family. Things they’ve done without all these years! We travelled, and had fun. I lived in the present, Doc. Don’t you get it?”
Wilson narrowed his eyes, trying.
McKenna shook his head at the oncologist, resenting every hair on his head. “Of course, you don’t. You’re a doctor. You’ve got lots of money, don’t you?” Beads of sweat were breaking out on his forehead and his face was flushed with alcohol and outrage.
“Well, I don’t!!” he screamed. “I maxed out my credit cards and after that, I got two more and maxed them out, too! I already had two mortgages on my house, and I haven’t been able to hold onto a decent job in four years.”
Wilson began to feel damp under the arms himself. He eased his chair back an inch or two. ‘If I could just think…’
But moving turned out to be the wrong thing to do. McKenna’s eyes widened in alarm and he pulled a pocketknife from his jacket. It was open and pointing at him in less than the blink of an eye.
James’ heart began to pound behind his ribcage. “Whoa, Mr. McKenna,” he began softly. He raised his hands slowly in front of his body, now desperate to diffuse the situation. “This will only make matters even worse. Please --”
McKenna seemed emboldened by the knife. “Too late for please. Get up, Doc.”
The doctor in Wilson registered the fact that his respiratory rate had shot up and most likely the colour had drained from his face, but he slowly stood to his feet, never taking his eyes from McKenna. He needed security fast. Hell, he needed somebody to know this guy was in his office! No, he realized with a sinking feeling, that’s not going to happen. ‘I need to get that knife, myself…now!’
“What’s your plan, Mr. McKenna? Hurting me isn’t going to make your problems go away.” He began to edge slowly out from behind his desk, hands still raised. “In fact,--”
“Shut up!! Shut up!! It’s your fault! Now it’s all a mess!” McKenna used his free hand to wipe his broad forehead. Wilson noticed it was shaking badly. He also saw the knife hand had drooped at the same time.
He’d never made a move in his life that he felt less confident about, yet he lunged for McKenna’s right hand before he could change his mind. He had the man’s thick wrist tightly in both hands and wrenched it with all his might. Unfortunately, this left him wide open to McKenna’s other fist which plowed mightily into the right side of his mouth, splitting his lip and snapping his head violently sideways. He fell awkwardly over his desk, sending his monitor crashing to the floor. Before he could scramble up, McKenna was on him, having retrieved the knife. If Wilson thought he was angry before, he was purple-faced and enraged now.
One of McKenna’s large paws held his chest firmly to the desk, while the other pressed the pocketknife to his carotid artery. One clumsy slip and Wilson was finished. Afraid to move his upper body in any way against that knife, even his legs were pinned as McKenna leaned directly into him.
“That was stupid, Doc,” the man whispered, breathing heavily, still reeking of alcohol.
For his part, Wilson was focusing on getting air into his lungs before his former patient crushed his trachea. With his head forced back on his desk, the blood spilling from his lip ran through his teeth and pooled at the back of his throat. When he was forced to finally swallow, he choked on the volume of blood and spit some back in McKenna’s direction. This caused his assailant to release his bruised throat and haul him up by his tie, knife still at the ready.
“Now what?” Wilson croaked out, dizzy from the rush of fresh oxygen to his lungs. McKenna looked into Wilson’s face, seeming to make a decision of some sort. Jerking his tie again, he forced Wilson to his knees and commanded, “Take out my shoe laces.”
“Excuse me?” he responded in real confusion.
“Do it!” The knifepoint pressed sharply into his throat again for additional emphasis.
Wincing, and fresh out of clever ideas, James reached out and removed the laces from McKenna’s walking shoes. When he was done he reached out with them only to hear, “Tie them together - tight!”
With that done, McKenna took the lace and stepped behind Wilson quickly, forcing both his arms behind his back to secure his hands. Not sure where the knife was during this, but feeling the absence of a sharp point in his throat, all Wilson realized was, ‘I can’t become this guy’s captive!’
Terrified he was about to find out where that damn knife was, he pushed the fear down, sprang up on one knee and turned, elbowing McKenna in the ribcage and using his weight to knock him off balance. McKenna, however, was built like a Tonka truck and barely staggered, while reaching into his back pocket.
James spun around, prepared to lunge for McKenna again, but went instantly sick with dread as he saw the glint of a pocketknife in front of him. Next he felt a heavy hand clap down hard on the nape of his neck; saw red beady eyes staring malevolently into his, and heard his voice issue a scream of surprise and pain as McKenna’s blade made it’s way into his right side.
This healthy man, who now had oh so many more problems, watched in drunken horror as his oncologist blinked in stunned disbelief for a moment, then clutched his bleeding side and fell to his knees.
* * *
The last one to leave Diagnostics tonight, House stood painfully to his feet at his desk, thigh pounding relentlessly at the moment, and dry swallowed a Vicodin. He collected three or four medical journals, stuffed them into his backpack and reached for his cane.
His hand stopped halfway as he looked up and saw Wilson’s ‘cancer’ patient from the day before lurching erratically down the hall toward the elevators. His eyes were wild, darting furtively all around him, as if he were afraid to be seen. He was clearly just leaving…Wilson’s office!
“Oh, God,” House muttered out loud.
Despite his leg, House would have won the 100-metre dash down the hall over anyone today. Wilson’s door was open and House swallowed down the bile in his throat that the vivid images in his mind were producing. Once inside he found Wilson face down, conscious but gasping, his white shirt rapidly wicking up bright red blood like a sponge.
“Wilson!” He threw his cane aside and fell beside him, fishing for his cell phone and touching Wilson everywhere at the same time.
“House,” James groaned deeply, trying to bring his legs up to ease the pain.
“Shut up! Save your strength…Put Cuddy on the phone, now! Cuddy? It’s House! I need a gurney and an ER team up to Wilson’s office now!”
He shouldered the cell phone and gently moved Wilson onto his side while he spoke to Cuddy. Carefully lifting his shirt high, he saw the laceration to the lower abdomen freely bleeding and his breath caught in his throat.
“House! What’s going on? Tell me!” Cuddy’s voice pierced through.
House unfroze and grabbed for Wilson’s clean lab coat from the rack, winding it around his arm.
“Wilson’s been attacked. Stabbed. He’s shocky. I need that team, now!” He stopped to press the lab coat down over the wound and winced as Wilson cried out, writhing.
“And lock down the hospital, Cuddy! There’s a lunatic patient on the loose!” He pitched the cell phone aside and felt for Wilson’s pulse. As expected it was shallow and rapid. His pale face shone from a fine sheen of sweat and his eyes were tightly closed. His lower lip was split and swollen; his chin caked with dried blood.
“Wilson?” House fumbled for his hand and squeezed it. “Wilson!”
The brown eyes fluttered open again. “House….hurts, House.”
“I know. Hang on, help’s coming.” Helpless to do much more than wait for help, House tried his best to stem the flow of blood and comfort his best friend. He gently brought Wilson’s knees up slightly, as he’d seen him struggling to do, easing the strain on his belly. He was semi-conscious now, in and out, mumbling incoherently. House had removed his jacket and fashioned a makeshift pillow for Wilson’s head and shifted from his knees to lay on his side against Wilson’s back; better able to keep steady pressure on the wound and hoping his leg would let him get up and moving once help arrived.
Wilson leaned back into House once he realized he was behind him, whether for comfort or warmth, House wasn’t sure. He closed his eyes and willed the ER to move faster, feeling Wilson begin to shiver from progressing shock. Using his free hand, he briskly rubbed Wilson’s side from shoulder to hip, rousing him at the same time.
“Mmmm, I’m cold,” Wilson noted, almost curiously.
“Yeah, Jimmy, lean back. Help’s on the way.” He whispered, trying to keep the fear out of his voice. He tried not to imagine losing his friend over something this senseless and stupid.
The noisy wheels of a fast moving gurney interrupted his waking nightmare and his heart leapt in his chest. “In here!” He shouted unnecessarily. “Move it!!”
Cameron was first into the room, carrying an IV set, catheters, tape and scrub. House locked eyes with her for a second, but right now she was all business. She took in House’s bloody hands pressing on the soaked lab coat, instructing one the paramedics she had snatched from the ER to grab sterile gauzes and replace Dr. House. The other one wheeled the gurney directly to Wilson’s side.
“IV first, don’t lift him yet,” she ordered. While she quickly swabbed his hand and opened a catheter, she quietly marvelled at House as he arranged Wilson on his back with the utmost tenderness. The oncologist was now ashen and unresponsive and she willed herself to focus on the patient again. Only seconds later the well-placed IV was running free flow and taped in securely. The medics sliced through clothing, placed ECG leads and an oxygen mask with equal speed and efficiency and soon they were all racing down the hall to the elevators.
Two and a half hours later Dr. Chase emerged from OR #4 and walked toward his former boss waiting at the end of the long hallway. House was sitting, staring at the floor, bouncing his cane on its rubber tip, and looking like the most forlorn man in the world. Then he detected Chase and the mask went back on before he looked up.
“Well?” House asked in a perfectly level, almost gruff tone of voice.
Chase was about to address House on a personal level, but thought better of it and looked him in the eye, reciting the medical facts.
“The surgery went very well. The knife did no damage to any major organs, even though the blood loss was significant. The only concern we had was that the blade pierced Wilson’s intestine, causing some leakage into the abdominal cavity. But sterile lavage was very thorough; there’s no reason to think his sutures won’t hold, so I’m pleased. His B.P. was adequate by the time we rolled into surgery and he remained stable the entire time because we were continuing to transfuse him. He’ll need a boatload of antibiotics for six weeks or more, but I don’t see why he shouldn’t make a complete recovery.”
Chase tore off his surgical mask and twirled it around his fingers, waiting for any questions or acknowledgment of his report, but House had looked away. Irritated, Chase thought to himself, ‘Thanks for your help, Dr. Chase. Don’t mention it, Dr. House.’
It finally dawned on Chase that he was watching House fight to control his emotions. His eyes were closed, and his Adam’s apple was working up and down furiously. He was accustomed to dealing with the emotional reactions of family when he came to them directly after surgery; everything from grief and devastation to immense relief and hysteria. He just didn’t expect it from House. It made him feel strange inside. He suddenly felt like a voyeur standing there. House made no move to get up in front of Chase, but he coughed and quickly wiped a hand over his eyes.
“Well, yes. That’s all then…” he began again. “They’re taking him to recovery as we speak. I’m sure you can see him in ICU in about an hour.” He turned to make a hasty retreat.
“Chase?”
He turned back. House was on his feet, rubbing his thigh. His eyes were moist and red, yet he came and stood in Chase’s personal space, staring him down.
“Thanks. I mean it sincerely. But if you ever tell a living soul about this, especially Wilson, I’ll eviscerate you. Seriously.”
Harsh, fluorescent lighting stabbed into Wilson’s eyes as he blinked his way back to consciousness. He licked his dry lips and stirred, feeling pleasantly buzzed out, still coming back from a far away place.
A moment later he shot upright in the bed, eyes wide with renewed fear. A strong arm came from nowhere and embraced his upper chest and shoulders.
“Stop! Get off me!” he shrieked, despite being quite hoarse from the ET tube.
“You’re okay. Wilson, it’s over. You’re safe. It’s me. Don’t thrash around, it’s got to hurt like hell.”
Sure enough, growing awareness and his sudden movement brought hot pain to his abdomen and he groaned and slid back down into the sheets. House reached over him and hit a button on the morphine pump.
House gave him a few moments to settle before speaking.
“That better?”
“Hmmm, yeah.”
“You’re a moron, you know that?”
“Wha--?” Wilson’s brow furrowed as it dawned on him he was about to be lectured, even now, in his vulnerable condition. Worse, there was nowhere he could go.
“Now will you stop trying to take responsibility for every hard luck case that comes your way, especially now that we know when you encourage them, they turn out to be fucking nutjobs!” He practically spit in Wilson’s face expressing his sarcasm.
“House,” he replied weakly, “how could I possibly have known--”
“Doesn’t matter! You open yourself up, literally, in this case, where you have absolutely no liability. He wasn’t your responsibility! And was he grateful for $6000.00? No! He tried to kill you!!”
Wilson lay quiet, looking defeated. This House could not tolerate, and he reached out and combed his hand through Wilson’s tousled hair, fluffing his pillow awkwardly when he was done.
Wilson spoke first.
“I’m sorry for scaring you.”
House grunted. “You won’t change though.”
“Not if it means I stop caring.”
“Precisely,” House grumbled with feigned irritation. He settled into the uncomfortable chair beside Wilson’s bed, accepting what Wilson had said, realizing he wouldn’t have it any other way.