Chapter 15: Routine Disruption
The clinic at nine AM is a battlefield disguised as a waiting room.
Three days since the Rebecca Adler case closed. Three days of House testing me with impossible questions, Cameron watching me like I'm a puzzle she's trying to solve, and Foreman treating me with grudging professional respect.
Today I'm back on clinic duty. Four hours of the mundane, the desperate, and the lying.
Wonderful.
Patient one shuffles in before I've finished my coffee. Sixty-something male, overweight, breathing hard from the walk down the hallway. The smell hits me before he sits down—sweet, almost fruity. Not cologne. Not sweat.
Acetone.
"What brings you in today?" I ask, already knowing.
"Just a checkup. Been feeling tired lately." Ringing. Lie. He's here because someone made him come. Wife, probably.
"When's the last time you had bloodwork done?"
"Year ago. Maybe two." No ringing. Truth.
I pull out my stethoscope. "Let me listen to your heart and lungs."
The exam takes three minutes. Heart regular but working hard. Lungs clear. Blood pressure elevated. And that smell—unmistakable once you know what you're looking for.
"You have diabetes." I pull up the lab order form on the computer. "Probably uncontrolled for months. That's why you're tired. Your body can't process glucose properly, so you're basically starving at the cellular level while your blood sugar skyrockets."
He blinks. "I... what? How do you know that?"
"You smell like acetone. That's ketones—your body breaking down fat for energy because it can't use the glucose in your bloodstream. Classic sign of uncontrolled diabetes." I finish the lab orders. "I'm ordering bloodwork. If I'm right—and I am—you'll need to start medication today."
"But I feel fine—"
"You feel tired and thirsty all the time. Probably urinating more frequently. Maybe some blurred vision. You've been ignoring it because you're scared of being diagnosed." No ringing when he nods. Truth. "I get it. But ignoring this will kill you. Come back in two hours for the results."
He leaves, shaken. I'm documenting when the next patient walks in.
Patient two through fourteen blur together. Sprained ankle. Upper respiratory infection. Prescription refill. A kid with strep throat. Another person who definitely just wants antibiotics they don't need.
And every lie triggers the ringing. Every deception hits like a hammer to my skull.
"I've been taking my blood pressure medication regularly." RING.
"I don't smoke." RING.
"The pain is unbearable." RING—not lying about pain, lying about the cause. Drug-seeking behavior masked as injury.
By hour three, my head is splitting. The aspirin I took earlier is useless. But I keep going because that's the job.
Patient fifteen is different.
Young woman, early twenties, nervous hands. She sits down and immediately looks at the floor.
"I've been having stomach issues," she says quietly. "Nausea. Fatigue."
No ringing. Truth.
But her body language is screaming something else. The way she's protecting her abdomen. The slight flush to her cheeks. The careful way she's sitting.
"When was your last period?" I ask.
She tenses. "I... two months ago. But I'm irregular, so—"
"Any chance you could be pregnant?"
Her eyes go wide. "No. I mean... I don't think... we've been careful."
Half-truth. The ringing is softer, uncertain. She genuinely doesn't know.
"I'm going to recommend a pregnancy test. Along with bloodwork to rule out other causes of nausea and fatigue." I keep my voice gentle. Non-judgmental. "Whatever the result, we'll figure out next steps together. Okay?"
She nods, still scared but slightly relieved someone's taking her seriously.
I send her to the lab and move to the next patient. Check the clock—fifteen patients in four hours. Double the normal rate for clinic duty.
Maybe I'm working too fast.
I'm documenting the last case when Cuddy appears in the doorway.
"Dr. Chase. Impressive work this morning."
I look up. "Just doing the job."
"You saw fifteen patients in four hours. Most doctors see six to eight in that time." She crosses her arms. Not hostile, just curious. "How?"
Careful.
"ER training. Brisbane Central ran high volume. You learn to assess quickly and move on. Pattern recognition becomes automatic."
"House mentioned you're very observant." There's something in her tone. A question she's not quite asking. "He's been asking questions about you."
"House asks questions about everyone."
"True. But he's usually trying to tear people down. With you, he seems genuinely curious." She pauses. "Just be careful. When House gets interested in someone, it usually means he's found something he doesn't understand. And House hates not understanding things."
Third warning this week. Everyone's telling me House is coming for me.
"I'll keep that in mind."
She leaves. I finish my documentation and head upstairs to diagnostics.
House is waiting.
"You're too efficient."
I stop in the doorway of his office. He's sitting at his desk, feet up, staring at me like I'm a specimen under glass.
"That's a complaint?"
"It's an observation." He swings his feet down. "Fifteen patients in four hours. Diagnosed uncontrolled diabetes from smell alone. Caught pregnancy before the patient even suspected. Identified drug-seeking behavior in under thirty seconds." He stands, grabs his cane. "That's not normal clinic work. That's either genius or you're cutting corners."
"Pattern recognition. I told Cuddy—"
"Yeah, I heard the ER story. High volume, rapid assessment, blah blah blah." He limps closer. "But pattern recognition doesn't explain how you read people's pain levels before touching them. How you know someone's lying before they finish the sentence. How you process information faster than people with actual photographic memory."
My pulse spikes, but I keep my face neutral. "Body language. Micro-expressions. Basic behavioral observation."
"Prove it." House grins. "I've got three patients waiting downstairs. You're going to assess their pain levels by observation alone. No touching. No questions. Just look and tell me what you see."
Oh, hell.
"Fine."
The first patient is easy. Middle-aged woman, holding her side, face tight with genuine pain. No ringing when she says "Ten out of ten."
"Seven, maybe eight," I tell House. "She's in real pain but functional. The way she's holding herself—protective but not immobilized. If it were actually ten, she'd be unable to walk."
House nods. "Kidney stone. Confirmed by CT. Good. Next."
Patient two is harder. Young guy, claiming back pain. The lie detection triggers immediately when he asks for "something strong for the pain."
"Two. Maybe three." I watch his face. "He's not in significant pain. Watch how he moves—fluid, no guarding, no muscle spasm. He's performing pain, not experiencing it."
House calls down to the exam room. Confirms the patient walked in without assistance, sat down normally, no physical indicators of acute back injury.
"Drug-seeking behavior," House says. "Correct. Last one."
Patient three is a test. Has to be. Elderly man with arthritis, genuine chronic pain. But he's underreporting because he doesn't want to be a burden.
"Six. But he'll tell you three." I meet House's eyes. "Chronic pain patient. He's used to it, learned to function through it. Body language shows constant low-level discomfort—the way he shifts weight, favors one leg. But he'll minimize it when asked because chronic pain patients learn that complaining doesn't help."
House checks the chart. "Rheumatoid arthritis. Told the nurse his pain was three. You're right."
He dismisses the patients and turns back to me. Studies me with those calculating eyes.
"That's not pattern recognition. That's something else."
"That's experience." I don't back down. "Eight years seeing patients lie about pain, exaggerate symptoms, hide problems. You learn to read the physical tells. It's not magic."
"No. But it's unusual." He taps his cane against the floor. "Interesting."
He lets me go. But I know this isn't over.
He's testing. Gathering data. Building a case.
And I just gave him more ammunition.
Cameron finds me at my desk an hour later.
"Heard House put you through the wringer."
"Standard House behavior." I don't look up from the patient file I'm reviewing. "Testing to see if I'm actually good or just lucky."
"And?"
"Apparently I'm good. Or he would've fired me already."
She sits on the edge of my desk. "You know, I've been watching you work. In the clinic. During the Adler case."
Here we go.
"And?"
"You're genuinely kind to patients. You remember their names, explain things clearly, don't dismiss their concerns." She pauses. "That's rare. Most doctors our level are either terrified or arrogant. You're neither."
"I'm just doing the job."
"No. You're doing it well." She hesitates. "But I've also noticed you wince sometimes. Like you're in pain. Are you getting migraines?"
Damn. She noticed the lie detection headaches.
"Occasional tension headaches. Stress from clinic work, probably. Nothing serious."
"You should get them checked out." Her concern is genuine. "Chronic headaches can indicate—"
"I know what they can indicate. I'm a doctor." I soften my tone. "But thanks for the concern."
She nods, still not quite convinced, and heads back to her desk.
She's noticing too much. House is testing too aggressively. The balance is slipping.
I close my eyes for a moment, letting the headache fade to a manageable throb. The lie detection is Phase 1—uncontrolled, always active, painful. I need to find a way to manage it before someone figures out it's not normal tension headaches.
One week as House's fellow. Already walking a knife's edge between competent and impossible.
How long can I maintain this?
The afternoon brings routine work. Patient follow-ups. Lab reviews. Nothing dramatic.
But when I leave at seven PM, exhausted and aching, I know the real test is just beginning.
House is watching. Cameron is noticing. The team is forming opinions.
And tomorrow brings new cases. New chances to help or expose myself.
One week down. The rest of my career to go.
I drive home through darkening streets, already planning how to survive tomorrow.
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