Chapter 2 - Smoking Joker

Holmes (Ekyt) put a pot of coffee on. He took a long gulp from the cup of strong regular coffee he already had. The diagnostics office was empty, save for the light from his desk lamp and monitor screen. It wasn’t strange since it was 2:00 am. Dan didn’t want House to resent his presence. So he had pulled an all-nighter learning neurology. It was some deal Dr. Cuddy had cut with the University of Rochester, which was the most prestigious school nearby. But he would have done it anyway. About four hours later, Dr. Cameron walked in.

Cameron: Good morning

Holmes: Good morning Dr. Cameron

Cameron: How long have you been here?

Holmes: (Counts cups of coffee) I’d say, judging by how much coffee I drank…all night.

Cameron: House’s busy work?

Holmes: No, working on my degree. Dr. Cuddy worked out a deal with a college that if I intern here, I’ll get my degree in Neurology and Pediatrics. Maybe Psychology.

Cameron: You pulled an all-nighter studying? (impressed)

Holmes: Yeah. I really want to be good at this. I know House doesn’t trust me…

Cameron: He doesn’t trust anyone

Holmes: Yeah, but I don’t want to give him any more reason not to

Cameron: …

Holmes: I’m sorry, would you like some? (Holds up coffee pot)

Cameron: Sure, thanks. So, what are you looking up?

Holmes: Studying previous cases that diagnostics has handled. I’ve got a lot to live up to.

Cameron: You’ll do fine. You’re smart, and you’ve got a great attitude.

Holmes: Thanks. Without you and Chase recommending me, I wouldn’t be anywhere. It meant a lot.

Cameron: I meant every word.

Holmes: (Smiles, straightens tie and pulls sleeves down, and brushes hid hand through his hair. He’s had a long night of studying). Thank you.


In a convenience store…

“Hands up chump!” A man in all black yelled. The pimple-faced clerk raised his hands. “Hand me all the cigarettes you have!” “C-Ci-g…” The kid gurgled. “You heard me!” The kid collapsed, coughing. “Good choice chump.” The man in black grabbed the cash register drawer and as many cartons of cigarettes as he could carry.

A few minutes later, a middle-aged African-American woman walked in. She screamed. “Oh my God!” She called 911 on her cell phone.


Back at the hospital…

Holmes yawned, downing another cup of coffee. Chase walked in next. “Morning Chase.” “Hey Holmes.” “Coffee?” “Sure, hit me.” Chase mumbled as he looked at the schedule. “Damn, I forgot! I’ve got that seminar today! In Hackensack!” Chase turned to Holmes. “You and Cameron gonna be alright today?” Holmes nodded. “No problem. No House today?” “His day off.” Chase explained. Holmes shrugged. “I’ll just catch up on paperwork then, since Cameron’s got clinic duty.” Chase gave him a look. “I’m sorry. Cameron seems to like you.” He observed, somewhat questioning. “There’s nothing between us Chase. We’re co-workers.” Chase nodded. “Sorry. I get a little defensive.” “I understand.” Chase looked around. Somehow, Dan Holmes seemed like someone he could talk to. “Her and were together briefly…one night. I just get a little worried that she might end up…you know… “with” someone, on the rebound. I just don’t want her hurt.” Holmes nodded. “Chase, I meant to thank you for the letter of recommendation.” Chase grinned. “No problem. This way I can keep an eye on you.” He joked. “I’m tricky, better watch out…”Holmes warned, grinned back.

Cameron looked at the 12 year old boy with his mother in the waiting room. “Well, hi! What seems to be the matter?” she asked, friendly. “He’s “massaging” himself constantly, and is starting to” “Whoa, your boobs are huge!” (NOTE: IF THIS IS OFFENSIVE, PLEASE LET ME KNOW, I WILL REMOVE IT! IT’S FOR STORYLINE PURPOSED ONLY, NOT MEANT TO BE PERVERTED!) Cameron’s smile wavered a little. “Thank you. Now” “Are they real?” “Jesse!” His mother exclaimed. “I think I can tell what’s wrong, and it’s perfectly normal.” Cameron assured her. “Puberty.” The mother’s face dropped. “Oh…oh…that DOES make sense…Thank you.” Cameron forced herself to smile.

Wilson came in to diagnostics. “How’s it going “Holmes?”” Holmes leaned back. “I pulled an all-nighter studying, and more paperwork today. But I’d be lying if I said I didn’t enjoy it somewhat.” “Did you check the time? Lunch Time.” Holmes looked at his watch. “Geez, you’re right.” “Want to go grab something? I normally eat with House, when he’s not making me pay for it.” Holmes laughed. “Sure. Let me just ask Cameron if she wants anything.” Wilson smiled at that. “What?” Holmes asked, surprised. “Seems you like her, that’s all.” Wilson put his hands up in mock fear. “I do. She’s great at her job, friendly, and she recommended me.” “That’s not what I meant.” Wilson said, still smiling. “What DO you mean?” Holmes asked, seemingly puzzled. “I think you know.” Pause “See you in the cafeteria.”

Holmes went to find Cameron. He found her sitting in the employee lounge. “Cameron? I’m going to lunch. Do you want something?” Cameron pushed her hair out of her eyes. “Sure. What are they serving today?” “Something they’re calling steak. What it really is, I’m not sure.” “That sounds good.” “All right, I’ll bring up. I’m not hungry today; I’m just going to keep Wilson company for a few minutes. Then I’ll have your food up.”

“What’s good today?” Holmes asked Wilson. “McDonald’s” Wilson grumbled, looking disdainfully at his processed meat. “I think I’ll skip lunch today.” “Me too, actually. I’m just going to bring this up to Cameron.” Wilson smiled, but said nothing of it. Instead he said, “Well, if you two need help today, let me know.” “Will do. Thanks.”

Cameron was sitting in the diagnostics office. She was wearing reading glasses. Holmes couldn’t help but notice that, with that frown of concentration, her features were even more pretty. Cameron glanced up. “Oh, sorry, I was reading this report. Thanks for getting the food for me. Let me pay you then.” “No, that’s okay.” Holmes responded quickly. “Are you sure? I mean…” “No, I feel I should thank you.” “Well, that’s nice of you, I” Their pagers suddenly buzzed angrily.

Dr. Cuddy was standing over the bed in the emergency room. “Male, 17 years old. He passed out during a robbery at the convenience store he works at.” Cameron took note of his cough. “Cameron, you get the patients history. Holmes, you keep an eye on him. I’m going to call his family.” “Does House know?” “Not yet. If we need him, we’ll page him. Oh, that’s right. Holmes, Wilson is going to supervise you.”

Holmes stood across the room, next to Wilson. “That cough is disturbing.” It was constant, too. Hack hack hack. Then it stopped. Holmes rushed over. “NURSE!” Wilson raced over. “No pulse.” Holmes informed him. “I’ll operate the paddles. Try CPR until the nurse gets here!” Breath, 1-2-3-4-5 chest compressions, breath. Holmes pushed on the chest and forced air into his lungs, trying to get the heart restarted. “rate falling!” Wilson indicated on the monitor. The nurse rushed in the paddles. “Charging…clear!” Wilson put the paddles to the kid’s chest. Zap! “Raising volts…charging…clear!” Zap! “Charging…clear!” Zap! Holmes looked at the monitor, which stopped beeping. “Heart rates rising…pulse is back.” Wilson handed the paddles to a nurse.

Gregory House was playing his piano, expertly, when his pager buzzed. He ignored it for the first four buzzes as he finished the piece he was playing. He hobbled across the room to check it.

“Here’s that report Dr. Cuddy.” Lisa Cuddy looked up to find her new neurologist-in-training looking hassled. “What happened to you?” “All-night studying session, and then a heart failure on that case you gave us. Wilson got his heart going again. Chase is back, monitoring him and running a few tests. And Cameron paged House, so he should be here any time.” Cuddy rubbed her temples. “Thank you. And, please, call me “Lisa” or “Cuddy.”” “Gotcha.” Holmes answered. “Well, head back to diagnostics for now. I’m sure House will give you some crap work.” She smiled at his professional attitude as his lab coat swished out the door.

House was writing on his white board when Holmes came back in. “Glad you could join us.” House had written “Cough, Heart failure, blackout” under a heading that said “symptoms.” House continued. “Go play with the kids in pediatrics. Let the grown-ups handle this.” Holmes paused for a second, but left with a small nod.

House turned back to the board. “What causes a cough, heart failure, and blackouts?” “Auto-Immune?” suggested Chase. “You go get a blood sample, and run the test.” House ordered. “What if the three aren’t related? A cough indicates a cold or flu, which causes fatigue. Maybe the kid worked too hard?” “Doesn’t explain the heart problem. Kids don’t have heart attacks for fun like adults do.”

Derek Michaels was sitting up, coughing, and cursing when he did because it hurt the burn marks on his chest. A blonde doctor walked in. “Derek, right?” he asked, in a thick Australian accent. “Yeah.” Derek coughed. “That’s a nasty cough. How long have you had it?” “’Bout a week.” Chase wrote that down. “Okay, let me see your arm. I just need a blood sample.” Derek obediently raised his arm. House put the needle in. “That hurt?” Chase asked. “When are you gonna put the needle in?” Derek was looking the other way. Chase, looking slightly alarmed, poked his arm with the needle again. No reaction. “Derek, the needle was in you. You didn’t feel it?” “No. *cough* Is that bad.” Chase hesitated. “Could I get a phone number for your parents, or guardian?”

Cameron browsed through the possible diseases, infections, and viruses it could be. “AIDS is most likely.” She concluded, snapping the book shut. House was tossing his tennis ball to himself. “Hmm.” “House?” “Oh, sorry, I was just thinking about you nak- I mean” “Christ, give it a rest, will you?! This boy could be dying!” “We don’t know that until the tests come back. Speaking of that, where is the Australian chap?” Chase made his appearance, bursting into the room. “He didn’t notice when I stuck the needle into his arm.” “Which means…” House prompted. “Bad circulation? That could be a collapsed vein, or a blocked artery.” House wrote those on his white board. “Congratulations Cameron! You get the gold star for today!” Cameron couldn’t help but smile at that. “Why don’t you go see what our junior lackey is up to?”

“Alright, great job! Look at my finger.” Holmes moved his finger back and forth, watching the child’s eye movement. “Okay. No hernias, heart is normal, eye look good. I think you’re set. Here, this is for the road.” Holmes handed the little boy a lollipop. The boy licked happily as Holmes cleaned up. “Thank you Dr. Holmes.” “It was no problem Mrs. Weinstein. You’ve got a really well-behaved son.” “Thank you!” “Have a good day.” Dan told her. “You too.”

Holmes walked out, almost bumping into Cameron. “I’m sorry!” He told her. “No problem. House sent me to check up on you.” “I’m not surprised. Did I pass inspection?” “You’re great with kids.” Cameron told him honestly. “I used to coach and referee hockey, and I helped teach martial arts. Probably where I get it from.” Cameron considered that for a moment. “Hmm…do you have a guess on this case?” Cameron explained the symptoms. “Well… I don’t have a guess. Does he have a history of heart problems? Or does he smoke?” Cameron shook her head. “No one’s asked him, he’s been in and out of consciousness all day. And his parents don’t know, but of course they believe he’s an angel, or course.” Holmes laughed at that. “Hmm, he’s close to my age. Most of the guys my age are anything BUT angels.” Cameron decided to bring him to House.

“He could get answers we can’t! They’re close to the same age. There’s the built-in teenage rebellion, too.” House rested his chin on his cane. “If you think Yoda there has the force with him, go ahead.” Dan Holmes made no indication that he even heard the sarcasm. “I’ll have a report for you in a few minutes.”

Derek was talking with his mother when Dr. Holmes knocked on the door. “Derek, right?” Derek nodded. “I’m Dr. Holmes, you can call me Dan.” Turning to Derek’s mother, he said “Could I talk to him alone for a few minutes?” “Anything you can say to him you can say to me.” His mother was a heavyset woman, in her late thirties. Her muumuu did nothing to make her look thinner, and she looked incredibly stern. “It’s very important to your son’s health. I just need a couple minutes with him.” “Listen here, young man” “Mom! It’s okay. (cough).” She gave Holmes a hard look, but stepped out.

House was sitting in Wilson’s office, eating his lunch. Wilson came in. “House, how did you get in here?” “Key.” House held up a key. Wilson widened his eyes and shook his head. “And I’m just…going to go out on a limb and assume that’s MY lunch you’re eating.” House looked at. “This could be anyone’s peanut butter.” Wilson sat down. “I assume you’re here for a reason.” “I think my new case has cancer.” “That would explain the cough and the blackout, IF the cancer is in his lungs. But what about the heart problem?”

Holmes pulled up a rolling stool. “Be honest. I’m not going to tell your mother. And I’ll be honest in return: If you lie, your life is at risk.” Derek gulped hard. “What do you need to know?”

House was pointing at his whiteboard when Holmes walked back in. He handed house a stack of notes. “He’s a smoker, has been since fourteen. The males in his family have had heart problems, going back several generations.” “Schedule him for a tox screen and a lumbar puncture. I’m going to enjoy the remaining two hours of my day off.” House limped off. “What he didn’t mention is that it’s the neurologist that does the lumbar puncture…” Chase muttered. “Wilson could do it. Chase, can you handle the tox screen?” Cameron asked. “Sure.” Chase asked. Turning to Holmes, she said “Thank you for the help. Would you assist Wilson?” “I’ll give it a try.” Cameron stopped him. “Hold on…what does that mean?” “I admit I’m…anxious over it.” Cameron smiled, somehow relieved. “You learn to get used to it. You’ve had so much heaped on you in the first two days.” “I’m fine, really.” She noticed a small twitch in his hand. She held the hand that was shaking. (Holmes’ neck turns red). “The first time a girl held your hand, right?” Holmes nodded, his mouth dry. Cameron let go, realizing she held on longer than she meant to.

Wilson and Holmes were ready. “Okay, I’m going to have you numb the area.” Holmes did. “We inject in” “between L3/L4 and L4/L5.” Holmes finished. “Right. And the patient is in…” “A…fetal position?” Asked the neurology intern. “You got it.” Let’s go ahead and do the procedure. You monitor his vitals and talk to him, while I insert the needle.

“We know he has cancer. But that doesn’t account for everything…The history of heart problems…what disease was it?” “It was hypertension.” Holmes responded. “That doesn’t explain everything either. Now, my little ducklings, what goes with hypertension?” “Stress?” Chase offered. “Kids are always stressed, they just don’t have heart attacks because of it. We’re missing something…” Cameron put her head in her chin, thinking. House Suddenly figured out. “Hypertension. In conjunction with the cancer. He didn’t pass out at the gas station, he had a heart attack. One so mild we didn’t notice it. The heart attack was caused by the hypertension, and Thromboangiitis Obliterans, or Buerger’s disease. Common among smoking jokers. They get their tobacee fix, but they pay for it…usually with a leg, but in this case, an arm. Wilson?” Wilson checked the test results. “I think we’ve caught the cancer early enough. Six monthes of chemo. The Buerger’s, though, unless he quits smoking cold-turkey…” “What about steroids?” Cameron asked. “They haven’t been proven effective.” “But it’s worth a shot.” They both looked toward House. House raised his eyebrows. “I’m flattered you want my opinion. Do both.”

(Start track: Hotel California by The Eagles)

Holmes, Cameron, and Chase watch as Wilson begins the first chemotherapy treatment. Holmes went over to talk to Mrs. Michaels. Her expression softened, finally showing tears.

Cameron watched Holmes comfort her, telling her he would be fine. Chase grinned mildly. “Another job well done.” He said in a joking manner. “Yeah…” Cameron looked over at Holmes once more as he walked away, Mrs. Michaels finally calming.

House was in his office, twirling his cane, thinking about God knows what. Holmes came in. “You needed to see me?” House stopped twirling his cane. Without a word, he handed Holmes his new ID card. Dr. Daniel Holmes. Diagnostics.

Wilson watched Dan Holmes show his new badge to Cameron. He grinned and nodded as she shook his hand. He mentioned something about “Grabbing some food.” Cameron agreed.

(End Track Hotel California)

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