lit_luminary: (In my image (sort of))
[personal profile] lit_luminary
Title: Threshold of Change
Author: lit_luminary
Rating: PG
Characters/Pairings: Chase, Wilson, House; House/Chase mentorship/friendship; House/Wilson friendship.
Summary: With House’s record, arranging a new start for him was never going to be easy.
Note: This fic is a prequel of sorts to [ profile] damigella_314’s “A New Beginning.”  What follows is Chase’s perspective before House’s release from jail; she covers Wilson’s after.

“…You’ve been here the longest, learned all you can, or you haven’t learned anything at all. Either way, it’s time for a change.” —House to Chase, 3.24: “Human Error.”

“Six months in rehab, effective immediately,” Wilson says with a heavy sigh when Chase asks how House’s trial went, “and three in jail. The prison term means termination of his tenure, and Cuddy is suing for damages. He may lose his apartment.”

“He’s been through enough without going to jail,” Chase says. He can’t imagine what went through House’s head, what made him go right off his usual spectrum of madness—but property damage isn’t enough to justify the abuse House might go through in prison. “They couldn’t make some kind of deal?”

“That was the deal,” Wilson says. “It would’ve been a year in prison if he hadn’t agreed to the rehab.”

Chase sits down behind House’s deserted desk, reaching for that oversized gray-and-red ball and holding it between his hands. It’s been four months since House limped out of the ICU on a half-mangled leg and destroyed Cuddy’s dining room, and two weeks since he came back from Fiji or Tahiti or wherever he went and turned himself in for trial. Since then, Diagnostics has been shut down and its staff shunted into other departments, but when he’s not busy in ICU or NICU, Chase spends his time up here instead of in the lounge.

“And his job?” Chase asks after a moment.

“That’s up to the Board,” Wilson says. “The decision has to wait until a new Dean takes over, so there’s a small chance they won’t fire him.”

If he were here, House would make an acerbic remark about the stupidity of even thinking they won’t fire him, but Chase keeps his mouth shut. The lines of anxiety in Wilson’s face and the shadows under his eyes say he knows; he doesn’t need to be told.

After the first few weeks, the hospital grapevine loses interest in House: now that he’s in rehab and presumably soon to be fired, it needs fresher and more exciting gossip. There’s a brief buzz of new life when the court orders the sale of House’s apartment to pay for the damage to Cuddy’s home, but it eventually dies down.

Chase spends six months moving between ICU and NICU, between coding adults and too-tiny, too-fragile preemies: he learnt to do surgery after leaving Diagnostics, but he was an intensivist first, and it grounds him a bit to fall back on that, to reach for calm that doesn’t react to crisis.

He’s waiting for the Board’s decision: unless House comes back, there’s nothing holding him to PPTH, no reason not to start new. And honestly, even with Wilson to advocate for him, Chase doesn’t like House’s chances of securing a majority vote. Mayfield had been damning enough (not that most of the staff hadn’t already thought House was mental), but after stealing experimental drugs, after operating on himself in his bathtub, after a car straight through Cuddy’s house…

He can already imagine the Board members shaking their heads, casting pitying eyes on Wilson’s arguments, saying Very talented, but obviously unstable and finishing up with Liability. Because the anarchistic genius/insanity that makes House such an asset to his patients also means it’s unlikely any hospital in the country will hire him.

Experience has taught him belief in preparation for the worst. At home in the evening, he updates his CV to include the last seven years (fellowship with House, surgical qualification, then back to House again, though he’s not sure whether it’d been as an attending or as the holder of a record-length fellowship) and starts looking for positions in Australian hospitals.

With his experience, finding a job in intensive care or even surgery would be easy, but he finds himself looking for something like he’s done with House, wondering if any other hospitals had had Cuddy’s idea to devote a department to diagnostics.  He misses the challenge and variety of that work, and he’s learnt he does it well—that maybe, with enough years and practice, he could take students of his own.

St. Vincent’s in Melbourne had been Rowan’s territory; he’s not going back there—New South Wales, maybe?  Sydney Adventist Hospital’s page proclaims its mission “Christianity in Action!” and he clicks back to his search results immediately, thinking House would riot before he catches himself, realizes what the hell he’s thinking.

He’s being ridiculous. House would never

But with no home except Wilson’s, no job and no way of getting another, he might at least consider the possibility. Maybe if he’s offered something good enough to move for…

What would it take?

The hospital would need letters of recommendation and character references from fellows past and present, from every patient with any kind of power House ever treated, to help smooth over the more controversial aspects of his practice. Would need convincing that House’s reputation, even somewhat tarnished, could draw patients and funding. Convincing that House’s unique skills could be an asset.

House would need a handpicked staff, freedom to choose his own cases, someone to handle the administrative details he’s never wanted to bother with, and as little contact with ordinary patients as possible. He’d need an administrator willing to take the chance and look the other way. And he’d need Wilson, his confidant and counterweight, to keep him balanced.

From what he’s seen, House is the only one who means anything to Wilson. Chase has never heard from House (and given the intensity of House’s focus on the minutiae of Wilson’s life and his habit of musing aloud, he would have) about any visits from or to family. If House has to leave PPTH, he can’t imagine Wilson staying.

When the Board rules, if it rules the way he thinks it has to—he’ll talk to Wilson.

On the day of the Board meeting, Chase finds time to go upstairs to what was Diagnostics. One of the janitors is using a sharp-smelling solvent to remove the lettering from the door.

Wilson’s door is closed, and Chase can hear the dull thud of objects being tossed around. He draws and releases a long breath, then knocks.

“Yes?” Tersely. Not a tone Chase is used to from him.

“It’s Chase. D’you have a minute?”

Wilson opens the door, lets him in. He’s trying not to look annoyed, but he’s not entirely successful. “You obviously know how it went. The Board fired House. And as I’m sure you can deduce from the boxes and sounds of packing, I’m resigning.”

“I thought you might,” Chase says. He sits down on the sofa, looks at the open, half-emptied bookcases and the collection of mementos from young patients. “What are you planning?”

“To do whatever it takes to get House somewhere to go in the next three months,” Wilson says. He heaves a sigh, reaches up to knead his temples. “This’ll make five major hospitals he’s been fired from—five!—and that’s not even considering the obstacle of his criminal and disciplinary records.”

“I’ll write a letter, and I think the others would,” Chase offers. “And if you could get letters from his patients…”

“The bigger the better,” Wilson says, letting his hands drop. “Politicians, CEOs, that FBI agent maybe…”

“The baseball player. And the South Pole psychiatrist; her saying he’s sane will help,” Chase says. “And that doctor who used to research retinoblastoma.” He looks at the brightly colored models and plush toys on the shelf, remembers the little girl House had bought a year for. “Andie’s mum. Any doctor who’d work so hard to save a terminally ill child can’t be as bad as his record looks.”

“You’ve been thinking about this.” Now Wilson does smile. “And you’ve worked with House too long not to be plotting something.”

“I’m looking for a position in Australia,” Chase says. “If no hospital in this country would give House a job, maybe we could work together. I miss diagnostics, and it’d be good for him to get away from this whole disaster with Cuddy. And the weather’d be better for his leg; it almost never freezes or snows.”

Wilson is quiet for a long moment. “Putting half the globe between House and Cuddy sounds good,” he says at last. “And since I’m leaving Princeton, he’s going to have to move one way or another.”

Chase relaxes. “I’ve looked at a couple of hospitals—I’m thinking New South Wales, but it doesn’t have to be if anyone somewhere else is open to this.”

“E-mail that to me and I’ll look at it,” Wilson says. “And I’ll go through the files, look for any important patients we might’ve missed. If you want help drafting a proposal…”

“Mostly I want help representing House in a good light,” Chase says. “You’ve had more practice than anyone else, and you’re well-known enough for people to listen to.” He’ll do what he can, but he knows how it’ll look: six years working with House directly, people will say he’s biased at best, suffering from Stockholm Syndrome at worst.

“And you need help convincing House,” Wilson says with a nod. “This…shouldn’t come from you.”

“I know.” He stands up, gestures toward the bookcases. “Want help packing this until they page me for something?”

“Thanks, but I’ve got it. I’d rather have some space to think.” He rests a hand on the desk, looks rueful. “I have the most practice with this, but I’m going to need it. Either Mayfield or rehab or prison would’ve been enough to gloss over, and even assuming we pull it off, you know how House is with change.”

Chase thinks of insistence on reclaiming bloodstained carpet and grimaces.

“Exactly,” Wilson says. He’s probably thinking of an incident or three of his own. “But if he’s as rational as he insists he is, he’ll allow himself to be convinced in the end.”

“I hope so,” Chase says, and leaves.

The next two months are a blur of teleconferencing and collection of letters, putting job applications together. (Wilson sends in applications in House’s name, forging his friend’s signature with casual ease: “He’s forged mine; turnabout is fair play.”) It’s encouraging to see how many former patients remember House gratefully and are willing to write character references and letters of recommendation on his behalf, even after the damning news coverage of the Car Incident: the politicians, the FBI agent, the psychiatrist. Wilson talks to Andie’s mother, who writes a moving account of House’s refusal to give up on her daughter’s case.

Foreman, Taub, Thirteen all give him letters to add to the file. Kutner’s parents do, too—Taub must have talked to them—and Chase steels himself and phones Cameron. She’s predictably upset when he has to explain why House needs a new job, but she doesn’t insist that House poisons everything he touches, and the next week, a letter comes from Chicago.

And he writes a letter of his own.

To Whom it May Concern:

I am writing on behalf of my former employer, Dr. Gregory House. He supervised my fellowship in diagnostic medicine from 2002-2005, and I was privileged to work with him as an attending in 2007-2008.

House is infamous in the medical community, but even his detractors have to admit that he’s brilliant. He’s taught me as much in seven years as some doctors learn in a lifetime, and no one has greater dedication to finding answers for his patients.

Chase pauses there, considering dozens of cases—he hasn’t bothered to remember names any more than House does, but he remembers House in the office, paging through journals or intent on a backlit screen after he’d sent all the rest of them home. He remembers how he’d seize upon the subtleties that any other doctor—if he even saw them—would dismiss.

It takes a little longer to find a case he can describe without making House sound obsessive to the point of madness, or like a loose cannon who’d break a dozen laws to get an answer. He wants something that’ll show House’s humaneness as well as his preternatural attention to detail.

In the end, he settles on the not-schizophrenic only House had listened to, and on her son, whom House had saved from endless, fruitless efforts at trying to save her. Briefly describes the history, from the improbable DVT that House had followed to a vitamin deficiency when alcoholism was the obvious path, and continues:

An ultrasound of the patient’s liver revealed a malignant tumor, which was successfully resected. Shortly afterward, Social Services arrived and took her son into care. Dr. House checked the phone records, and discovering that the patient herself had made the call, he ruled out schizophrenia: an insane woman could not have taken such selfless action for her child. Close reading of the patient’s records revealed a missed appointment with an ophthalmologist; putting this together with psych symptoms and the cirrhosis, House deduced that the patient had Wilson’s Disease. She underwent treatment and was able to resume care of her son.

Most doctors would have dismissed this patient because of her mental health, or attributed her symptoms to any one of several more obvious diagnoses. At the time House took her case, her problems had already been mishandled and compounded by a parade of specialists. House’s refusal to make the usual assumptions, his insistence on treating the patient with dignity and listening to her, saved her sanity as well as her life. I point to this case as an example, but House achieved similarly great successes on a weekly basis. His practice was designed for the patients whose cases no other doctor could solve; the ones who would otherwise die undiagnosed.

Then he talks about Andie: another thumbnail-sketch history, tests that had turned up nothing but slightly low oxygen saturation, within range:

It was off by one percentage point. There were no other anomalies; at this point, even the patient’s oncologist doubted her hallucination indicated an underlying condition, but House insisted that even slight deviation from the norm was a problem. When testing showed the patient’s lungs were functioning normally, House ordered an echocardiogram, and listening to the audio, heard an extra flap in her mitral valve. There was a tumor growing along the heart wall, hidden by its location from any imaging studies.

Even the doctor who had thought to look at the patient’s heart wouldn’t have listened this way, not when imaging had failed to turn up any pathology. House’s willingness to question test results and his ability to use them in unusual ways were critical to diagnosing this patient, and shows the usefulness of physical diagnostic techniques—so often replaced these days by more technologically sophisticated methods.

He finishes that example with a description of the deductive process that’d led House to the clot in Andie’s head; how he’d devised a procedure to find it and give her one last year. Andie’s mother will focus on House’s humanity; he’ll flesh out the medical details, tell them the lengths House will go to not only for answers, but for a patient outcome. Tell them what he’d done for a patient whose prognosis would’ve led any other doctor to give up.

Finally, he details the proposal, the kind of department he hopes one of these hospitals will build; says that House’s skills would be an invaluable asset, that the patients his practice had served should have a chance.  Says that he recommends House without reservations, even though he knows anyone who reads the letter will think he shouldn’t.

Yes, there’s lot of obstinacy and lawbreaking and general madness that goes along with all that talent, and the medical community knows it. But he hopes, because if there’s any justice at all, genius like House’s has to excuse all that.

It has to.

A month before House’s release from prison, Chase comes home to a thick envelope in his letterbox, bearing an Australian postmark. It’s a job offer from Royal North Shore Hospital, New South Wales: vice-head of a newly instituted Department of Diagnostic Medicine. According to the letter, House is welcome to take the headship as soon as his medical license is reactivated.

Chase isn’t sure what he believes anymore, but he says “Thank you, God” as he puts the envelope down and reaches for the phone: maybe, just once, he’ll get what he hoped for.

Wilson picks up on the second ring. “I was just about to call. Two letters: one offering me the equivalent of a headship in oncology; another for House. Head of Diagnostic Medicine. Three fellows, full discretion to choose his own cases, and a maximum of four clinic hours a week.”

“Good,” Chase says. He moves over to the couch, sinks into the cushions. “We’ll each take the one extra.  They shouldn’t care, so long as it gets done.” Cuddy had only forced House into clinic hours in a misguided effort to teach him humanity.  She should’ve realized how many patient complaints that caused and taken him off the schedule.

“I’ll tell him that if he’s not showing enough interest,” Wilson says. Then, “My office would be next to House’s; that should be another selling point.” Chase can hear the smile, the gratitude. “I think there’s a good chance he’ll go for this. It’s the best possible offer.”

“He’s going to hate the move.”

“True, but he’d hate moving an hour out of Princeton just as much as he’ll hate moving halfway around the world,” Wilson says. “And having you in the office and me next door is familiar; that’ll make it go down easier.”

“I’ll give notice tomorrow,” Chase says. “Now that we have someplace to go, I just have to find a flat, get the last of the packing done, book a flight and have everything shipped.”

He’s already been packing everything but the furniture into boxes, looking at shipping companies and costs; that bit’s almost done with. Finding a place to live will take a little longer, but he’s reasonably sure he can do it within the next few weeks.

“You don’t have to rush. If you noticed, the start date is flexible, and it may be two or three months before House decides he wants to do this.”

“I know. But having a few months to learn the routine ahead of time couldn’t hurt, and I’m sure they’d let me spend the time in the ICU or NICU if they don’t want me taking Diagnostics cases before House arrives.” He toys with the edge of the sheaf of papers in his lap. “I want to move toward being settled again. It’s been worth it, organizing all this, but…”

“A lot of work, a lot of uncertainty, a lot of chaos,” Wilson agrees. “I don’t blame you for wanting some peace and quiet.” Chuckling, he says, “God knows you won’t have any once House gets there.”

They’re talking in terms of when, not if, but knowing how unlikely it is House will get a comparable offer anywhere else, that’s safe enough. House is, above all else, a rational man: in the end, he’ll take the best offer. Because he needs the stimulation of diagnostics, needs his own practice, or he might as well still be in prison.

Thinking of that crack House had once made about Chase’s being descended from convicts, Chase smirks: he’ll probably appreciate the irony of relocating to a country that used to be a penal colony.

“I’ll talk to him about this when I pick him up from jail,” Wilson says. “It’ll probably take a few weeks for him to adjust.”

“Would he mind if I visited before I left? I’ll leave breaking the news to you, but…” He knows House would probably rather not be seen in prison; it’s a blow to his dignity. Still, Chase doesn’t want to go without having said goodbye, even if it’s just temporarily.

“If you want to do that, there’s paperwork and a ridiculous amount of bureaucracy involved,” Wilson says. “You have to be approved by House and by the prison, meaning a background check and at least a week or two for them to process all the forms. Then they’ll make an appointment and send you a list of rules—the kind of identification you have to bring, things like that.”

He’s had enough paperwork for a year in the last few months, but he feels he should at least try. “You’ve obviously done all this before. Is it as much of a pain in the arse as it sounds?”

“It’s worse, but at least House appreciates the effort,” Wilson says. “I sent him a detailed description of the process after the first time I showed up and they sent me home because he was in solitary confinement for some undefined bad behavior.”

Chase frowns. “They didn’t call and say you couldn’t see him?”

“That would seem to be the polite thing, but they don’t,” Wilson says. “But since I informed him how much work is involved in coming to visit, House has made an effort not to lose the privilege.” A pause, then, “I’ll help you with the paperwork.”

It takes two weeks for all the relevant forms to clear. In retrospect, Chase thinks, he probably should have waited another week for House to get out of prison and visited then, when he wouldn’t have had to deal with regulations telling him everything from how many keys are allowed on his key ring (two, and no attachments) to what he’s allowed to wear and where he has to sit. He puts up with going through the metal detector, and with having his hand stamped with that ultraviolet-sensitive ink—as though the pass he’s carrying to get in and out isn’t enough.

He waits for twenty minutes before a guard escorts him to a visiting room. There are a few other prisoners, a few other friends or family members, the low hum of conversation. House is already there, sitting at a plastic table, facing a control booth where another guard is sitting. Chase is allowed to sit with his back to it, but knowing it’s there and they’re being watched is uncomfortable.

He’s been here less than half an hour and he’s already thanking God he never has to come back. It makes him wonder how House has put up with this and worse for three months and not gone completely out of his mind.

As it is, he looks half-sick and miserable, wearing an expression that means his leg’s giving him hell and he hasn’t been sleeping properly, and Chase can see a livid bruise, fading from purple, across his right cheekbone. He clenches his teeth on the urge to ask what happened.  House won’t want to tell him, won’t want to see his concern.

“So.” House musters a smirk. “Is this straight masochism, or did you have another reason for putting yourself through the prison security gauntlet?”

He’s not masochistic, or not more than anyone needs to be who thrives in House’s orbit. And he could say that, but he’s learnt House prefers to go straight to the point. “I’m leaving PPTH. I found a position in Diagnostics in Australia; I’m flying down in a few days.”

“And I need to know this from a prison visit instead of a phone call because?”

“I wanted to see you.”

“Right: a hundred pointless rules shoved down your throat, all for the fond memory of guards, dingy Formica and me looking like hell in a prison jumpsuit.” He shakes his head. “Not worth it.”

“It was a pain in the arse,” he says, “but it…mattered to me that I did it.”

“If you try to hug me, the guards will throw you out,” House says. Then, dryly, “I remember that look. And no one goes through as much crap as it takes to get in here because they’re being rational.”

“It’s irrational to care?”

If he’d said that under normal circumstances, at a time and place House had the choice to walk out, he probably would have. Now he stays seated, because ending the visit early just means going back to his cell early, and even a conversation he doesn’t like is better than that.

“Must you?” House says, grimacing.

“You said yourself I wouldn’t be here if I didn’t give a damn.” Then, “I wanted to thank you. The last couple of years…I learnt more from you than I could have from anyone else.” Not only about medicine, either, but House knows; he doesn’t need to say it.

House taps the fingertips of one hand softly against the tabletop. The patterns look random, but knowing him, he’s probably imagining piano keys. “A lot of people would say you’d have been better off without what you learned from me,” he says.

Rowan had told him when he accepted House’s fellowship that House was half-mad, a maverick whose approach would never be acceptable in the wider medical community; Cameron had told him House ruined him. “Yeah,” he agrees. “And I’m better off without those people.”

One corner of House’s mouth curves upward just a little. Chase knows that’s as close to a statement of approval as he’s ever going to get.

“So, they’re starting a diagnostics program in Australia now?” House says.

Chase nods. Part of him wants to give House the details, give him something to think about beyond just counting down the days, but he knows the chances of success are better if he keeps quiet and lets Wilson break that news. So he just says, “I’m going to be vice-head of the department.”

“Nice,” House says.

He might have said more, but a tone sounds and the guard says visiting time is up. House gets to his feet, bracing himself with one hand against the table; Chase stands, too. Says, “I’ll miss you.”

Not for too long, with any luck.

“You can send me a postcard.” A short pause, then, “If you have to do the hugging goodbye thing, watch my sixth to eighth left ribs.”

He nods and moves around the table, throat tight because he knows it’s no small thing for House to give, and hugs him with one arm, gently, avoiding his left side altogether.  House clasps one of his shoulders for a second, and then they let go. Guards start coming through the door to escort visitors and prisoners, breaking up the longer goodbyes, and House is taken back to his cell.

Back at the processing center, Chase shows identification and the ridiculous stamp, hands in the pass and goes home, thinking that even if it’s just for a few more months, it’d been worth the effort to visit and say goodbye.


Two months later, his cell phone rings, shattering a sound sleep. Chase reaches across the bed and gropes for it, stares blearily at the time display: six A.M.

House is calling.

Chase doesn’t think for a second he doesn’t know the exact time difference, and mutters “This’d better be good news” as he touches the right bit of screen to take the call. “Yeah?”

“Oh, did I wake you?” House sounds that particular kind of amused he always is when he knows he’s pushing buttons. “Sorry about that.”

“You’re not,” Chase says, trying to shake the fog of sleep from his brain, “and we both know you woke me up on purpose.”

“You put me through the big goodbye on purpose,” House says, “knowing it was only going to be a couple of months.”

Instantly, Chase no longer cares it’s an ungodly hour: House is taking the job. He’s taking the job, and right now, for one moment, Chase can almost believe in answered prayers.

“Hoping,” Chase says, not bothering to hide the sound of his smile. “Not knowing.”

“Should’ve been knowing,” House says. “Are you looking at CVs yet?”

“I wanted to hear from you before I—”

“I want the all the stupid candidates weeded out before Wilson and I get there in September,” House breaks in, “and mark the files you think I’ll like. That number should be in low single digits.”

“All right,” Chase says. “Anything else before you let me go back to sleep?”

“No. Goodnight.” And House ends the call.

People would say he should’ve said Thank you at the very least, made some explicit acknowledgement of everything Chase and Wilson had done, but Chase doesn’t need to hear the words.

He knows how to recognize the thanks in House’s taking the job, and it’s enough.

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December 2016


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