Chapter 11: Everybody Lies - Part 3
The OR is cold and sterile, all stainless steel and harsh lights.
Rebecca Adler's head is locked in the stereotactic frame, her skull exposed where Martinez made the incision. The bone flap is lifted, dura reflected, and now we're looking at actual brain tissue through the surgical microscope.
"Steady retraction," Martinez says. I adjust the retractor, maintaining the surgical field while he positions the biopsy needle.
The target is small—barely three millimeters on the MRI. A shadow that could be artifact, could be inflammation, could be the answer to why a healthy twenty-nine-year-old had a grand mal seizure in front of her kindergarten class.
Martinez inserts the needle with precision that comes from a thousand similar procedures. The stereotactic coordinates guide him to the exact location. The needle penetrates brain tissue with a resistance that's both sickening and fascinating.
"Got it." He withdraws slowly, and the tissue sample—barely visible—goes into the specimen jar.
I'm about to relax when I notice it.
The area surrounding the biopsy site shows discoloration. Subtle. Could be surgical trauma, could be the tissue's natural color under these lights. But there's a pattern to it—slight edema, vascularization that looks wrong.
"There." I point with my free hand, careful not to move the retractor. "That area. Three millimeters anterior. The tissue looks inflamed."
Martinez adjusts the microscope, focuses. His expression shifts. "You're right. Inflammation. Definitely not normal."
Wilson, standing across from me, leans in to look. "Could be reactive from the biopsy."
"Could be." Martinez repositions. "But it's worth sampling. Good catch, Chase."
He takes a second specimen from the inflamed area. The tissue looks slightly different—more vascular, redder, like something's causing localized irritation.
Larvae. Has to be larvae.
But I can't say that. Can't jump to conclusions without evidence. Just have to note the observation and wait for pathology to confirm.
The rest of the surgery is routine. Martinez closes the dura with interrupted sutures, replaces the bone flap, staples the scalp. Rebecca's vitals stay rock-solid throughout—heart rate steady, blood pressure normal, oxygen saturation perfect.
"Nice assist," Martinez says as we're closing. "Not many fellows notice tissue changes that subtle."
"Just paying attention."
"Keep it up. House's team needs people who actually look at what they're seeing."
We finish, and Rebecca's wheeled to recovery. I scrub out next to Wilson, the hot water washing away blood and betadine.
"That inflammation you spotted." Wilson's tone is conversational, but there's something underneath it. Curiosity. Maybe concern. "How'd you see it? Martinez almost missed it, and he's been doing this for fifteen years."
"Different angle, maybe. I was holding the retractor, had a direct line of sight."
"Still impressive." Wilson dries his hands, watching me. "House thinks you're different. More observant than normal."
Here we go.
"House thinks everyone's different. It's how he reads people."
"True." Wilson tosses his towel in the bin. "But he's usually right. Just be careful. When House gets interested in someone, it rarely ends well for them."
Second warning today. First from Wilson about House's curiosity, now this.
"I'll keep that in mind."
The pathology results come back six hours later.
We're all in the conference room—House back from wherever he disappeared to, Foreman reviewing labs, Cameron updating patient notes. I'm at my desk, documenting the surgical observations, when House's phone rings.
He listens for thirty seconds, face unreadable. Then hangs up.
"Pathology's inconclusive. Mild inflammation, no tumor, no obvious infection. They're running more detailed tests, but preliminary read is negative."
Foreman looks up. "Negative? But Chase saw inflammation during the surgery."
"Inflammation doesn't always mean infection." House limps to the whiteboard, starts erasing old differentials. "Could be autoimmune. Could be trauma from the seizure. Could be we biopsied the wrong spot."
"Or the tests are missing something," Cameron adds.
"Always possible." House writes new possibilities on the board. "But we're running out of options. If pathology comes back negative on the detailed studies, we're back to square one."
My phone buzzes. ICU calling.
I answer, already knowing what they're going to say. "Dr. Chase."
"She's seizing again. Second grand mal in the ICU. We need the team."
"On our way."
I hang up and look at House. "She's having another seizure."
The mood in the room shifts immediately. Second seizure means the condition is active, aggressive, and we still don't know what it is.
We move fast—down the stairs because House refuses elevators, through the hallways, into the ICU where Rebecca Adler is convulsing on the bed. Nurses are already administering lorazepam through her IV.
The seizure lasts forty-five seconds. Feels longer. Her body goes rigid, muscles contracting violently, jaw clenched. Then it stops. She goes limp. The monitors show post-ictal confusion, heart rate elevated, breathing shallow.
"Vitals stabilizing," the ICU nurse reports. "But that's her second seizure in eight hours."
House stands at the foot of the bed, staring at Rebecca like she's a puzzle that personally insulted him. "We're missing something."
"The biopsy was negative," Foreman says.
"The preliminary biopsy was negative. Doesn't mean there's nothing there. Just means we didn't find it yet."
Cameron checks Rebecca's pupils—equal and reactive, but sluggish. "We need to figure this out fast. Two seizures in eight hours is concerning. If she has a third—"
"We know what happens with status epilepticus." House cuts her off. "Chase, that inflammation you saw. Where exactly was it?"
I pull up the surgical notes on the computer, bring up the diagram Martinez drew. "Anterior to the biopsy site. Roughly three millimeters. Temporal lobe, near the hippocampus."
"Critical area for seizure activity," Foreman notes.
"And if there's something there causing localized inflammation—infection, parasite, tumor—it could trigger seizures without showing up clearly on imaging." House taps his cane against the floor. Thinking. "We need more than a biopsy. We need to see what she's been exposed to."
"How?" Cameron asks. "She won't tell us what supplements she's taking."
"She doesn't have to tell us." House's grin is predatory. "Her house will."
The room goes quiet.
"You want to search her house?" Foreman's voice is carefully neutral. "That's illegal."
"It's also effective. People lie. Their houses don't." House looks at each of us. "Medication bottles, supplement containers, dietary records, travel documentation—it's all there. We just have to look."
"I can't be part of that." Cameron's voice is firm. "Breaking and entering is a felony."
"Good thing I'm not asking you to break anything. I'll handle the entry. You'll just look around once we're inside." House's attention shifts to me. "Chase, you're coming. You notice things."
And here it is. The moment I knew was coming.
I could refuse. Should refuse. This is illegal, unethical, a violation of patient privacy.
But Rebecca Adler is dying. And I know what we'll find there.
"When?" I ask.
House grins. "Tonight. After visiting hours. We'll meet at her address at eight."
Cameron looks at me like I've betrayed something. "You're really going to do this?"
"She's had two seizures in eight hours." I keep my voice level. "If we don't figure this out, she might not survive the night. I'll take the legal risk."
"That's not—" Cameron stops. Starts again. "This isn't how medicine should work."
"No," House agrees. "But it's how diagnostic medicine works when the patient lies and the tests fail. You want to save her? This is how we do it."
He limps out, leaving us in the ICU with an unconscious patient and our own moral compasses spinning.
Foreman looks at me. "You know he's going to get us all fired if we're caught."
"Probably."
"And you're still going?"
I think about Rebecca Adler. About the inflammation I saw during surgery. About the fact that I already know what's wrong but can't say it without exposing everything.
"Yeah. I'm going."
The rest of the afternoon crawls by.
I update patient notes. Review the MRI images again, looking for anything we missed. Read articles on neurocysticercosis, preparing for what I already know we'll find.
At seven-thirty, I leave the hospital and drive to Rebecca Adler's address. It's a small house in a quiet neighborhood—neat lawn, flower beds, the kind of place where kindergarten teachers live.
House's motorcycle is already parked down the street. I pull in behind it and wait.
Foreman arrives five minutes later. Then Cameron, looking conflicted but determined.
House walks up to the door like he owns the place. Pulls out a lock pick set.
"Seriously?" Cameron whispers. "You carry lock picks?"
"I carry a lot of things." House works the lock with practiced efficiency. Thirty seconds later, the door swings open. "After you."
We enter Rebecca Adler's home like thieves in the night.
Because that's exactly what we are.
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