Final four
After the drinking night, you woke up at 6am in the on- call room since you did not have time to return back home, thanks to Cameron keeping you in a random bar till you noticed the late hour. So you decided to go for a shower in the locker room, you pulled out an extra change of clothes with your citric perfume and makeup. The lab coat that was hanging now you were wearing it in order to head to the cafeteria catching a coffee before going to the auditorium. Shot of espresso and sweetener you asked for, even though you hated coffee without milk but being up late at the bar gave you no choice in the matter but you still wished you could order your comfort drink instead of the dirty water you drank to get through the day.
“Good morning sunshines. Today is the last day of this crazy ride. Only four of you will continue on riding so I wish the eight of you the best of luck and don't kill any patient”
“Wait, what is the last test?” Amber inquired
“Hoping for a really sick person to drop in, meanwhile go to the ER maybe you will find something”
Arriving at the ER you see paramedics rushing in with a man mid forties who was having a stroke so you run to assist .
“Hey, what’s your name?” You asked to see the extent of the brain damage since he wasn’t answering you asked again and proceeded to see if he knew where he was. Your bossed appear suddenly “I got a page as soon as he entered”
“He is not reacting and before the collapse the paramedics told me he was slurring words”
“Seems we have a case. Get him admitted and meet me at my office”
Once the eight of you were in Dr.House’s office, the discussion of the diagnosis started stating all symptoms this patient had shown in order to see which tests were worth doing to cure him. You were sent off to do the usual things like draw blood, take a urine sample, do a cognitive test assessment and a house search. You were the one doing the cognitive assessment, you realized that the patient was showing signs of aphasia since he was showing having trouble comprehending and communicating. Also involuntary muscles spasms. His home didn’t show anything that could compromise his health, in the blood the values of the white blood cells were normal which meant no infection. Every test indicated to find viruses active or inactive it came back negative. You spent six hours in the lab which was more than you ever spent there so you decided to get up to get some coffee. Looking for the cafeteria you decided to see if Cameron was around, instead you found your boss who didn’t miss the opportunity to acknowledge your presence.
“Nineteen, already finished the work?” He yelled from a chair
“No, just a coffee break. I am returning to the lab right now”
“I’ll join you then. Let’s go” He said, getting up to walk over to the laboratory beside you “So what did you find?” House asked opening the door to the lab letting you walk in first
“Everything is negative so far and I’m running out of things to test for” He sat next to you, your nervousness started to rise “So, the others got anything? “
“I haven’t been paged yet, so my guess is no. But are you trying to drive me away?”
“No, no, no” You started to stutter
“It was just a joke” He laughed “Well it seems like we got something” He said after his beeper went off.
In the office were the rest of your seven colleagues, who looked at you suspiciously since you entered with your boss walking behind you.
“What are you looking at? Better start talking about your findings” House said while you looked at the floor and played with your fingers in an attempt to calm you down.
The CT showed white matter spots in the brain meanwhile all the tests referred to the body appeared clean. The white matter spots were located in the deep brain and periventricular regions which discarded some other illnesses since not all of the ones that present white matter show in the same regions as the patient presented. You started to reread the file since you didn’t want to miss any symptoms. At that moment you catched on to the fact that the father of the patient had died at a fairly young age in a car crash and the details on that were vague so you decided to investigate a little more. While you read the police report it was registered that the fathers patient before crashing had already shown symptoms of confusion and disorientation witnessed by other drivers passing by. The forense report had stated that the driver had a stroke which caused the crash. You connected the dots and deduced that this could be an inherited illness, so with that in mind you returned to the lab to test for genetic diseases.
Other four hours passed by and a thousand of genetic testing later you had the answer to it, it was Cerebral autosomal dominant arteriopathy-subcortical infarcts-leukoencephalopathy type one which it affected the gene NOTCH3, with your discovery you run to your boss to tell him your findings. When you get to the office, you see your boss talking with a woman who has curly dark hair and was wearing a grey skirt with black tights and a black short sleeve shirt, it was somebody that you haven’t met yet. Since they seemed occupied you decided to sit in the bank that was behind to wait for them to finish talking but your boss called you in.
“Nineteen come here, don’t be afraid”
“Sorry I didn’t wanna interrupt”
“No, of course. You wanted our patient to die while I was being tortured by this unknown woman” She interrupted him “I’m Dr. Lisa Cuddy, so nice to meet you” She extended her hand to great you
“The pleasure is all mine” You finally looked at her
“This is so nice but we have a patient dying, You can catch up later” Your boss said
“He has CADASIL type 1. I discovered this by rereading the chart and then looking for the police report on the patient's father's car crash since he had a stroke before going into the truck. I’ve been testing inherited diseases for four hours till I noticed the mutation on the NOTCH3 which corresponds to CADASIL. I ordered to put him in ACE inhibitors”
“She’s a keeper” Cuddy said making you blush
“Yes, she is” Your boss replied grabbing the test results you had in your hands seconds before he snatched them “Let’s go tell the patient then”
Your boss and yourself went to the patient’s room while the Dean of Medicine watched you both with a strange frown in her face that you couldn’t quite read up on. After delivering the diagnosis and treatment, everyone got a page -even you when you were next to your boss- it stated to reunite in the auditorium where all of it had started.
“We are in the same spot where it all started, to finally come to an end for some of you but not for all. It's been fun and intriguing almost six weeks since the first time we stood here but it’s time to finally choose my team; the ones who will learn to be my right and left hand. Without further do, I will call you to stand up and give my decision. First the little one” Said your boss looking at Taub who seemed annoyed by the name calling “I like your nose, that’s it. Maybe you could be a good doctor. Now sit down. Thirteen… well who doesn’t need a hot bisexual in their team? Maybe the insight of your being could do us some good. Kutner being so silly sometimes makes you kinda smart sort of in a weird way. So your silliness may make the team seem smarter compared to you. And finally nineteen who is the only one that might pay attention to her surroundings just enough for her to notice stupid things that probably solves a case and also I like laughing at but well. That’s it. For the rest of you, the ones who weren’t called out, I wish you luck with your job searching thing. The rest of you I see you tomorrow bright and shine at 7am”