Thursday, April 14, 2005

12:07 AM

PG-13 for language

We said good-night to Dr Ball, and I had just turned towards the exit, when I heard Dr Ball say, in a low, firm voice, “Dr House. A moment, if you please.”

I froze. Shit. I was in trouble again, wasn’t I? But what for? I thought back frantically – I hadn’t insulted anybody, had I? I’d even been nice – well, civil – to the med students….

I started walking again, slowly. Lee and Van Horn, the last to go, waved good-night and disappeared through the door. I stopped and let Dr Ball catch up with me.

He was buttoning his overcoat. “Dr House,” he began.

He didn’t sound angry, but you never could tell with Dr Ball. I kept my eyes fixed on the door, waiting.

“I have a favor to ask you,” he continued. “This has been such a pleasant evening, and now that I’ve satisfied my craving for bacon and eggs, I’m finding myself with a taste for a long, rambling chat. Now, usually I would turn to Mrs Ball for the chat, but tonight I cannot, for I also find myself with a taste for some whiskey and a pipe, and she doesn’t share those tastes. I was hoping perhaps you might.”

I hesitated, and Dr Ball spoke again: “Now, by a pipe, I do mean tobacco in general, so if you don’t have your pipe with you, you could bring those things you smoke in your car.”

I was so busted. “Thanks, Dr Ball, I’d… I’d be honored to join you.”

“Thank you, Dr House.” He walked over to the pay phone. “I’ll just call Mrs Ball and let her know I’ll be bringing company tonight.”

As we walked out to the parking lot, I wondered if I would be having that smoke blindfolded in front of his back fence.

I followed him to his house. It was on the small side, in the same quiet, older neighborhood many of the university faculty favored.

He waited for me at the sidewalk. As I followed him to the front door, he nodded toward the side of the house. “If it were summertime, we’d be banished to that screened porch there,” he commented. “So perhaps we should be grateful for the cold and the damp tonight.”

He opened the door and I followed him in. “Cilla?” he called.

Mrs Ball appeared, wearing a long bathrobe over her pajamas and slippers. I stood by, awkwardly, as he greeted her with a kiss. “Cilla, I don’t think you’ve met Dr Gregory House. He’s one of the second-years on my team this rotation. Dr House, this is Mrs Ball.”

We shook hands. Mrs Ball seemed perfectly at ease, as if nothing were more natural than having some random resident turn up at ten o’clock on a Thursday night. She chatted briefly with Dr Ball about the day as he took my jacket and hung up his coat.

“I’ll see you a little later, then,” she said. “Good to meet you, Dr House. Don’t let him keep you up too late – he does tend to get hypnotized sometimes by the sound of his own voice. Good night.” She collected another kiss; Dr Ball watched her as she headed up the stairs.

He turned. “Shall we?”

As he led me through the house, I caught a few glimpses of family photographs and framed maps. We passed through the kitchen, dark except for the night-light over the stove, and through a short hallway into a cozy little room. An entire wall was given over to built-in shelves stuffed ceiling to floor with books. In the middle of the room, a sofa and two chairs were turned towards a fireplace, where a small fire was already going. “Ah, Cilla,” said Dr Ball, smiling.

He nodded towards one of the chairs as he headed over to a small cabinet. I sat down as he poured two drinks. He came back over, handed me one, sat down in the opposite chair, and lifted his glass. “Cheers,” he said with a nod.

I raised my own glass, nervously. He took a sip. Once I’d had my first taste, he put his glass down and turned to the table at his left. He selected a pipe from a little rack and slowly, deliberately, filled and lit it. Once he had the pipe going, he took another sip of his drink and gazed into the fire, drink in one hand and pipe in the other, a look of deep satisfaction on his face.

I started to relax a little. The only sound in the room was the crackle of the fire. After the constant noise of the hospital and the chatter in the restaurant, the quiet was almost disorienting.

I took another sip and felt myself getting warm. Maybe I wasn’t in trouble. But then why was I here? Dr Ball was such an enigma to me. I had a full tummy, though, and between the warmth from the fire and the warmth from the whiskey, I was feeling ready for whatever turn this conversation was going to take… if it ever got started…. I found myself relaxing into the chair, enjoying the soothing glow of the flames and the scent of the fire and the pipe….

I felt Dr Ball’s eyes on me. I looked up. He looked amused.

“So,” he said. “How long have you known Miss Abney?”

I looked away in chagrin for a moment. Of course he knew, he knew everything. “How…?” I started to ask, but I couldn’t finish the question.

“Oh, come now,” he replied. “Could it have been more obvious? You were downright sociable!”

I looked away. He was right, of course; I wasn’t Mr Congeniality. I knew it, I knew he knew it, I knew the whole team knew it; usually I didn’t care, but for some reason it stung to hear him say it.

“Why the long face?” he asked. “It was delightful to see. Miss Abney seems like a poised little creature, but she was so at ease with you, and you with her, in such a natural, playful way that it was obvious the two of you have met before. It made me very happy to see you talking with someone instead of glowering into your coffee cup. And it was... gratifying to see you putting yourself out to make sure our guest was at ease, especially when she was at such a disadvantage and yet… others couldn’t be troubled to do it. I was proud of you, Dr House.

“But I must confess… Mr Kopp’s look of surprise when I called him out tonight was certainly good for a laugh – he’s not a terribly self-aware fellow if he doesn’t realize that wrapping himself around a telephone like that announces to the whole world that he’s talking to a sweetheart. But I’ve known since the first day of this rotation that he had a little friend out there, and I’ve known for weeks that you’d met this little friend.”

I laughed a little. “I’ve got to ask. How?”

Dr Ball’s smile grew mischievous. “Mr Kopp’s been wrapping himself around that telephone from day one, and for a day or two there was something highly suspicious about the way you were needling him. But the clincher… well, I know I’ve always advised you to cultivate a prudent… skepticism towards patients and their stories. However, it’s important to remember the corollary, and that is that some patients are fonts of useful information.

"Mrs Walford, for example, is an excellent historian. By the way, were you aware that she and her husband have been married for fifty years?”

“Mrs Walford!” I shook my head -- I’d forgotten about her.

“I have to tell you, I think you made her week. After you two had left, I went back to check on her, and she had a great deal to say about how that nice Dr House was going to look out for that medical student and make sure he got something for his beautiful singing cheerleader girlfriend for Valentine’s Day. I was very concerned at first about her mental status and was going to order a pulse ox, finger stick, and ammonia level, but her husband confirmed the whole story.

“But enough about me. Let’s talk about you. How in the world did you meet Miss Abney? It seems unlikely that Mr Kopp introduced you; I’d be surprised to hear that you two were chums outside of work.”

“I… I was running an errand over on the main university campus, around the end of January. We met by chance.” I chuckled a little. “She actually recognized me first; I guess Kopp had pointed me out to her at the restaurant.”

“Running an errand. On the main university campus,” Dr Ball repeated. “A musical errand, perhaps? Oh, don’t give me that look, I know that you sometimes tune the office radio to the classical station when you’re on call, and then make sure you put it back to a rock station before the others come in. And I’ve seen how you tap out tunes when you’re thinking and drumming your fingers. But forgive me – now I’m just prying. So you first met Miss Abney in January. Had you seen her since then?”

“No, this is only the second time we’ve met.”

He puffed on his pipe for a moment.

“You like her, don’t you?” he asked.

“I don’t like her,” I protested.

“I wonder how many verbs French or Italian offers for expressing the different shades of friendship, esteem, attraction, affection that exist between men and women,” he mused. “They’ve got to be better than English, with this poor choice between ‘like’ and ‘love.’ I don’t mean ‘like’ in the sense of ‘wanting to date.’ I mean 'like' in the sense of 'like', in the sense of finding someone to be interesting, pleasing. So. Do you like her?”

I wasn’t sure what to say.

He raised an eyebrow. “I assure you, this isn’t a trick question. For my part, I like Miss Abney very much. She’s intelligent, she’s poised, she’s filial to her elderly relatives, and she can make it through an entire conversation without using ‘like’ as a, like, filler word.”

He took a sip of his drink. “Now that I think of it, I believe we also made it the whole evening without hearing the word ‘psyched.’ And her posture! This may come as a surprise to you, but I’m kind of an old-fashioned fellow, and I can’t tell you how refreshing it is to meet a young lady who doesn’t slouch. And even more refreshing -- she’s sincere. That’s a rare quality in these ugly times.

“So. Do you like Miss Abney?” Seeing my discomfort, he added, “Oh, don’t worry, I won’t tell anyone.”

I looked at my hands for a long time before I answered. “I think she’s funny.”

Dr Ball didn’t say anything. I finally looked up from the floor. He was giving me a long, searching look. I wondered what he was seeing.

“I wonder what kind of people Miss Abney likes,” he said.

“She likes Kopp,” I snorted.

“Ah, yes, Mr Kopp.” Dr Ball set his drink on the table and cradled his pipe in his two hands before he took another puff. He watched the smoke float to the ceiling.

“Mr Kopp,” he said again. “Yes, Miss Abney likes Mr Kopp. The question is, for how long? And does Mr Kopp like her?”

My stomach did a little apprehensive flip. “They’re dating.”

“They’re dating now,” said Dr Ball. “But I’ll be astonished if that couple sees a second spring concert. And unfortunately I think poor Miss Abney is going to have the worst of it. I hope it doesn’t jade her. But would staying in this… relationship for too long jade her even further?”

“Why do you think they’re going to break up?”

“You were there. You saw the same things I did.”

Suddenly I remembered seeing Kopp kissing her. I shoved the memory away. “I don’t think I did,” I replied.

“Well then you saw, but you didn’t observe,” said Dr Ball. “Conversationally, he left her hanging out to dry at least twice when she was a stranger at the table. You could make the excuse that he’s had enough of madrigals, I suppose, but it’s still lacking in courtesy. And if he’s sick of madrigals already….

“Here’s a big clue: the necklace. Not that lovely antique watch, but the necklace she didn’t show us.”

I sat forward, intrigued. “Did you observe,” he continued, “how much time it took her to get her necklace off? Now, why would it be so difficult, particularly when the chain was so long she could have just slipped it over her head?”

“Sticky clasp,” I guessed.

He shook his head. “You need more women in your life, Dr House. No, she was untangling the chain. It wasn’t tangled in her hair, and it wasn’t caught in her clothes. So what else would she be untangling the chain from? I think it was another necklace, a necklace she didn’t want to show us at all.

“Now, what kind of necklaces do girls hide? Not ones that are merely decorative. So it’s a necklace that means something. What could it be?”

I felt my brain being drawn to the puzzle. “A Medic-alert necklace. Maybe she wasn’t embarrassed, but she just didn’t feel like talking about it.”

“A good thought. I think she’d be more likely to wear a bracelet, but that’s a good theory.”

“What’s your theory?”

“She could be wearing some kind of jewelry that Kopp gave her – maybe a ring on a chain – but then wouldn’t it seem strange that she’d want to keep it hidden instead of wearing it proudly? Of course, she could also be wearing a piece of jewelry some other beau gave her that she doesn’t want Kopp to see. But I doubt that's the case.”

He looked into the fire and puffed on his pipe a little while before he spoke again. “I suspect that Miss Abney is not as serene as she seems. She’s drawn to Kopp, and up to now has followed where he’s led her, like a little fish swimming after a bigger. But she’s a little fish who has already been caught by another; she’s caught by an unseen hook, an invisible line. She may resent it, or she may not even be aware of it, swimming along unknowingly. But she will only be permitted to swim so far. And then she’ll feel the hook in her mouth, the tug on the line, the gentle twitch upon the thread. And she will be able to follow him no further.

“Unless she fights the hook. In which case, she’ll tear herself apart.

“You weren’t there, were you, when she and Kopp were leaving. So you didn’t see how admiringly she looked at Mrs Patel, and how obviously Kopp wanted to get out of there.

“I wonder who’ll be next on Miss Abney’s dance card? I’m sure she could be very good for the right man. I just hope that that man, whoever he turns out to be, will think very carefully about whether he’s good for her.”

“Anyway, as I was saying, I do like Miss Abney very much, and I’m very sorry I wasn’t able to finagle an introduction earlier. I’m so glad that she told us about this spring concert. Our little group is coming to an end and we’ll all go in different directions, and if not for this concert I doubt we’d have the opportunity to see her again.

“Have you received your assignment for your next rotation?”

“Yes,” I said, trying to conceal my displeasure. “I’m going back down to General Medicine.”

“Oh! with Dr Ogilvie’s service?” My face told him he was right, and he chuckled harshly. “Well, well. I’m sure you’re looking forward to that assignment.”

“Thrilled,” I muttered.

“I shall have to write an appraisal of your time on my service, of course, and pass a copy on to Dr. Ogilvie.”

Here it came. I put my drink on the side table and waited bleakly for the usual end-of-rotation scolding. Dr Ball raised his eyebrows.

“Were you expecting a negative evaluation? If you were, I’m afraid I’ll have to disappoint you. I’ll have plenty to say about your clinical acumen, especially in cases with unusual presentations, and about your potential as a teacher. Dr Sachs and Dr Lee have certainly learned from you, and even Van Horn’s learned some new tricks.

“And there’s going to be no ‘but’ in this evaluation. I’ll recommend that you continue to work on your skills with procedures and put a special emphasis on professionalism. And that’s all. We’ve had a good rotation; when I’ve had occasion to correct you, I did it right away, so I don’t see a need to pass anything forward. There’ve been no egregious slips, nothing worth committing to paper.

“I know you’ve worked with Dr Ogilvie before. I hope you’ll continue the progress you’ve made over the last eight weeks and not let the frustrations of that service get to you.

“This is the first time I’ve had the pleasure of working with you, Dr House, and when I say ‘pleasure’ I’m not being glib. I have enjoyed working with you, very much.

“Now, I knew before we started this rotation that there were going to be some… challenges ahead….”

I looked away, no longer able to meet his steady gaze.

“Yes, I’d gotten the whole earful. It looks like you have, too. And I know that Dr Ogilvie has, so I didn’t feel the need to repeat it. Perhaps my positive review will inspire him to… approach your time together as a fresh start. I hope so, for your sake and for his.”

“Yes, you heard me correctly: for his. When we find ourselves in conflict with others, that’s our chance to examine ourselves, to consider the possibility – however unlikely – that we might bear some of the responsibility. And I think there’s a grain of truth in what you no doubt tell yourself after each new scathing evaluation: there is some envy involved. Even such splendid creatures as attending physicians are subject to the same failings that plague every other poor soul on this planet, including envy and pride. And, of course, there’s the tendency to hate others for having the same faults we can’t bear to admit we see in ourselves. No one hates the proud more than the proud man. We really are our own worst enemies, aren’t we?”

He cupped his pipe in his hands. “I know it’s hard. It’s hard to be patient when other people don’t care about something that you know is important. It’s hard to know how to reply when you’re reprimanded for doing what you’re supposed to be doing. It’s hard when everyone’s very quick to tell you what not to do, but no one bothers to teach you what you should be doing. And it’s hard to be… misunderstood, particularly by people who don’t understand because they’re lazy, or they think their way is the only way. I know for myself I grow annoyed when others imply I’m not a ‘team player’ because I’m not committed to golf. They don’t understand that I see dinner with residents to be a much better investment of my time. Let others hobnob with the admin types and the donors. I’d rather focus on teaching.

“Dr House, you’re an intelligent fellow: a sharp clinician, and, as I’ve said, a good teacher… with the potential to be an excellent teacher.” He puffed on his pipe, looking to the fire. “These are some of the qualities I look for when I make my nomination each winter for our next year’s Chief Resident. Do you think you might like to be Chief Resident next year?”

I stared at him. “I… I never…”

His eyes narrowed. “Am I to understand that you have been here for almost two calendar years, and I am the first one to discuss this topic with you? Disgraceful. A physician with your perception and intelligence should be on everyone’s short list.

“Now, a good Chief Resident is perceptive and intelligent, but those aren’t the only qualities he possesses: Being smart and being effective aren’t necessarily the same thing. A good Chief Resident understands that, and puts being smart to use in being effective. I hope you’ll remember that, and continue to put your intelligence to work in learning to become more effective.”

He cupped his pipe in his hands again as he watched me. I could hardly look at him. Was he really saying all this?

We sat in silence for a minute or two. Finally he looked up at the mantel clock.

“I can’t speak for you, of course, but I do need a certain amount of sleep to function as an effective attending physician….”

It was late. But it was still so difficult to leave that cozy fire behind and follow Dr Ball back to his front door.

I pulled on my jacket. “Thanks again, Dr Ball. See you in the morning?”

“Of course, Dr House. Thank you again for coming; this has been a most congenial evening.” He watched me zip my jacket. “Drive safely. Oh, and one more thing – quit the cigarettes. Take up a pipe. Pipes are better for you. They certainly smell better. And they’re more civilized, more… contemplative. I think you could use more contemplation in your life.”

He chuckled at my blank expression. “Good night, Dr House.”

I paused and looked over my shoulder as I went back down the front walk to my car. The downstairs lights were already winking out.

I didn’t put the radio on. I passed the restaurant as I drove back; its lights glowed cheerful and yellow in the clammy drizzle.

Back home. I really wasn’t up later than usual, so it seemed strange to be so sleepy. I tossed my mail on the kitchen counter and started emptying my jacket pockets. Keys, cigarettes, a couple of candy wrappers… a folded pale green flyer… the folded menu, crayon games and all. CARDIOVERSION.

I found myself smiling a little. What a weird night. I threw my jacket on the table, poured a little milk, sniffed it, filled the glass, and headed off to the bedroom.


Blogger Sanlin said...

Alright, now that my posts aren't returning an *error* message, I can comment, again... :-)

Dr. Ball reminds me of some of my kewler Profs at University eons ago. ;-) Small wonder you turned out to be as great as you are with such a wonderful mentor. :-) I have no idea what the story is with your biological father (and I'm not asking or prying), but, it seems to me that Dr. Ball must surely be the 'father of your spirit.' Just as, in turn, you've become a bit of a Daddy Duck to your own Ducklings.

I'm glad someone recognized and encouraged your talents early on. That means a lot to anyone finding their way through this world.

He was a very insightful fellow, that Dr. Ball. Not that you're generally any slouch in that department, yourself, Doc. It's only when people get too close to a situation, to wrapped up in it, that it becomes difficult to maintain focus and objectivity--that's why matters of the heart are some of the things that can genuinely tear us apart.


April 18, 2005 11:29 PM  

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