Ten Days Later, 9 a.m. - Monday
On this, the last day of the inquiry, the panelists sat once again in their assigned seats, conferring quietly. Across from them, several people were seated on hard chairs identical to the one that had previously held just one witness. Present in the room were James Wilson, Darryl Nolan, Eric Foreman, Robert Chase, Remy Hadley, Jessica Adams, Chi Park, Chris Taub… and Gregory House, who sat with his head down, staring blankly at the floor as he bounced his cane up and down on its rubber tip. He wore a tweed driving cap with the brim pulled forward, shading his eyes.
The last to enter the room was Lisa Cuddy. When she saw House, her eyes widened slightly and her body stiffened. Clenching her jaw, she grabbed the remaining chair and dragged it as far away from him as she could, setting it down firmly on the floor before sitting down. The others formed a group, as if they were trying to present a united front.
"Ladies and gentlemen," said the panel chair, tapping the base of his pen against the long table to get their attention. "Thank you for attending this final session. We appreciate the testimony from all of the witnesses who have spoken before us, and are particularly pleased to have heard from several people who contacted us unsolicited. Some of them have provided unique and valuable perspectives. First, let me tell you we are unanimous in our findings and our determination."
The panel chair removed a pair of tortoiseshell glasses from a case in his breast pocket, perching them upon his nose. He rustled a sheaf of papers in front of him and began to read from his notes.
"After careful review of all the testimony and the medical and psychiatric evidence, we have come to a series of decisions. Before we announce these decisions, we enter into the record the results of a physical exam and a series of CT and MRI tests Dr. House underwent last week at our request, as well as affidavits from some of Dr. House's more famous patients, including the President of the United States, who has reported that Dr. House saved his life.
"We also submit a statement we received earlier this week from Dr. Robert Chase, who has admitted clogging the Princeton-Plainsboro Teaching Hospital plumbing with the shredded tickets previously blamed on Dr. House, the act that led to the revocation of Dr. House's parole."
At this, a small, self-satisfied smile graced Chase's face. There, he thought. After all this time, we're even now, House. You saved my career after my mistake, and now I've done my damndest to save yours. He glanced surreptitiously toward House, and their eyes met for just a moment. House bowed his head almost imperceptibly in thanks before turning his gaze back toward the floor.
"We are sorry to report that the CT and MRI results show repeated and cumulative brain injuries in the prefrontal cortex, the area of the brain that affects judgment, impulse control, management of aggression, emotional regulation, self-regulation, planning, reasoning and social skills. These brain injuries include a number of falls and accidents, and were probably triggered by the severe skull fracture he experienced, and the lack of effective treatment for that injury.
"In addition, the deep brain stimulation and the seizure it caused seem to have caused some minor damage to the hippocampus, where memory is stored and which also affects emotional control. The scans show some slight damage to the hypothalamus, although we are not sure why that area was affected. Fortunately, with medication, the symptoms caused by those injuries - which seem to have affected only his emotions and impulse control - not his intellect - should be manageable."
The man cleared his throat, took a sip of water and went on. "We also regret to say the scans of his brain show a couple of small tumors in the prefrontal cortex, which, fortunately, appear to be operable. A biopsy has shown them to be benign, but the placement of them suggests they could affect emotional stability, judgment and impulse control as well. As far as we can tell, these tumors appear to have resulted from the side effects associated with the untested medication Dr. House used in a desperate attempt to resolve his long-term pain issues."
House's mouth dropped open slightly in surprise as others in his group sent him sidelong glances to see how he was responding to this startling news.
When the panel chairman said, "…the CT and MRI results show repeated and cumulative brain injuries in the prefrontal cortex, the area of the brain that affects judgment, impulse control, management of aggression, emotional regulation, self-regulation, planning, reasoning and social skills," Cuddy audibly gasped, her thoughts turning inward, not really hearing what was going on around her.
Quite simply, she was shocked. No one, not herself, not Wilson, not even House's team, had done what this panel had done, which was to track down an underlying physical cause for the fairly substantial changes in House's behavior over the couple of years beginning right before his commitment at Mayfield.
Her mind raced, going back over her interactions with House during that time. How could she not have noticed how much he had changed, how much more out of control he'd seemed? How could she have missed it? House's anguished outburst when she pushed him to express his feelings, his sudden turnaround from pleading with her to go back to their previous way of dealing with each other… and then, within hours, driving his car into her home… it all suddenly made more sense. His brain was damaged. He hadn't been completely in control of his emotions. And no one, herself included, had even considered the possibility that there might be a physical cause.
She couldn't seem to get her head around the idea that House had been suffering from physical issues that had affected how he had behaved. For two years now, she had spent every moment of every day resentful of how his actions had affected her, constantly fuming, completely convinced that he was a violent domestic abuser, and perhaps always had been one. Why hadn't anyone noticed how much he had changed? Not only had they not noticed just how hard he had tried to create a better life for himself following Mayfield, but they also hadn't seen it as he again began to disintegrate during his relationship with Cuddy. Why hadn't someone suspected something was wrong and tried to find the answer? Why?
Her testimony before the panel had shaken her self-confidence. She had been forced to face - and admit - that her own behavior had been less than stellar. Cuddy had always perceived herself, not just as a great administrator, but as a good person. Now she wasn't so sure. For the past ten days, as the panel deliberated, she had found herself unable to sleep, unable to eat, unable to stop thinking about the issues brought up during her testimony. Every time she remembered some of the things she'd said to House, some of the things she'd done to him, it had made her feel horrible.
She realized that, practically from the beginning, when House's leg injury first happened, she had behaved herself badly, always setting a higher standard for House's behavior than for her own. Now she had no choice but to examine her own numerous ethical lapses, but also how her professional and personal conduct over the years had affected the people around her, and in particular, House.
For the first time in her life, Cuddy had reflected on her own behavior, feeling dirty, ashamed, and very uneasy… feelings she'd never had before. Now, to find out about the brain injuries and tumors, and how they had affected House, her whole perception of the universe was shaken. It was almost like waking up one morning to find out that she wasn't actually Lisa Cuddy, administrator extraordinaire, but instead was some other woman, a woman who couldn't tell right from wrong, who couldn't seem to use her brain instead of her emotions, and who did rather despicable things to someone she claimed was a friend, a lover and a disabled employee. She felt hollow inside, as if someone had scooped out the essence of the person she thought she was.
Slowly, Cuddy resurfaced, aware again of her surroundings, but feeling vacant, the revelations making her feel like she had imploded. While she was still deep in her own thoughts, the panel chairman had continued.
"Going into this inquiry, we were well aware of Dr. House's reputation, both professionally and personally. We knew he was detested by many of his fellow doctors at Princeton-Plainsboro, and that he tended to alienate colleagues, superiors and patients alike. It is apparent from reviewing his history that Dr. House has had an enormous capacity for self-destructive behavior, and has brought some of his problems on himself."
At this, House shrugged, as if to say, "So what else is new?"
"Dr. House's physical dependence on Vicodin has certainly not helped the situation. Given his pain levels and ongoing concerns with his pain management - or lack thereof - it is understandable how that dependence escalated into pseudo-addiction. Pseudo-addiction, as you know, is a condition with symptoms similar to those of addiction, but which results specifically from untreated or undertreated chronic pain. Despite the beliefs of some who have known him - and we cannot state this strongly enough - we do not believe Dr. House has been addicted to Vicodin, but instead has been physically dependent on the medication, which eventually led to pseudo-addiction because his pain was not treated as well as it should have been."
Wilson glanced over at House in time to see a fleeting look of astonishment pass across his friend's face, quickly replaced by his usual frown.
The panel chair continued: "As a result of our findings, we do not think that all of Dr. House's behavior can be blamed exclusively on his personality. It's apparent that brain injuries and tumors have undoubtedly affected his actions. In addition, we have also determined that there has been considerable negligence, if not outright malpractice, by some of the people entrusted with Dr. House's medical care.
"To make what we're saying crystal clear, we believe there were major extenuating circumstances affecting some of his decisions and behavior. In particular, it appears that his mental breakdown was precipitated, at least in part, by repeated head injuries and, specifically, by the skull fracture and deep brain stimulation. His delusion about Dr. Cuddy and the hallucinations that preceded it could not have been caused by his Vicodin use, as has been assumed up until now, but rather by those brain injuries and/or long-standing depression, either of which could have created, among other problems, his confabulated memory.
"In addition, it is our considered opinion that the violent act leading to his incarceration was brought on by those same untreated injuries, aggravated by additional injuries, the tumors and the three subsequent surgeries. He was still recuperating from those surgeries, and should no doubt have been remained hospitalized, when the violent incident took place. The medical evidence strongly suggests that his self-surgery, insistence on checking himself out AMA following three back-to-back surgeries, as well as the reckless violent act itself, were caused by the brain injuries and tumors affecting his judgment and impulse control."
At this pronouncement, Wilson's eyes opened wide. I really am an idiot, he thought. Why has it always been so easy for me to blame House's troubles on his personality and not even try to find a medical cause? Especially when I apparently created one of the biggest of those medical problems myself. What kind of doctor do I think I am, anyway? And what kind of friend?
As Wilson drifted into remorse, the panel chair continued: "As should be obvious by now, we did our homework before coming in here, and we know of Dr. House's history of recklessness, self-destructive behavior and occasional borderline - and sometimes not so borderline - illegal activities. That said, we also believe that some of the things that have taken place could have been prevented.
"Dr. House, there is no question that you have a talent for angering the people around you, whether colleagues, superiors or patients, and you also have a knack for getting in your own way. Your antisocial tendencies are well documented. However, those issues are not under review here. What we are examining, instead, are any mitigating circumstances that might have contributed to the course of events.
"The man we have unearthed through this process is someone who hid his most sensitive feelings far away from anyone who might use them to hurt him... and that includes his best friend at times, as well as Dr. Cuddy. For some reason, Dr. House, you were willing to show that gentler side of yourself to some patients and, on rare occasions, to others. What most people saw, however, was a rude, push-the-limits kind of a guy who seemed to have a shaky grasp of ethics or legal issues, who seemed determined to push people until they couldn't stand him anymore, and who did a great deal of harm to those around him and, perhaps just as damaging, to himself.
"Dr. House, although you have behaved unethically and even illegally at times, we believe that, over time, you have done more good than bad. You have been forthcoming with us about these failures and have expressed willingness to pay the legal price for your actions.
"It has become apparent to us that you have, for many years, served the medical community well, even though, as we have already noted, you have been more than a bit cantankerous, unorthodox and eccentric in your dealings with coworkers and patients. Professionally, it's obvious that you value the truth above everything else, but it's equally obvious that you aren't always aware of it in your personal life. But it is equally clear that you yourself have been severely ill-served, not only by people whom you considered to be friends, but also by the medical and legal establishments, which should have made greater efforts to uncover these underlying medical causes and treat them before some of the unfortunate circumstances occurred."
The panel chair glanced up over his glasses and gazed at the assembled group. After glancing first at Wilson, who squirmed under the scrutiny, and then on Cuddy, who sat up straighter in her chair, setting her jaw, he finally settled on House.
"Dr. House, based on these findings, we hereby reinstate your medical license immediately, and recommend that all previous legal charges be stricken from your record."
Before anyone else had a chance to react, Cuddy sputtered. "But he destroyed my house!" she said, her voice coming out a little more loudly than she intended. "He should pay for that!"
The panel chair stared her down, until she grew quiet. "Dr. Cuddy, please! Restrain yourself. You know perfectly well that Dr. House has more than paid for what happened to your home. He willingly submitted to a longer sentence than was required by law, and many of his assets were seized, with no argument from him, to cover the damages to your property. He has accepted complete responsibility for his actions, even though some of them, it is now clear, were beyond his control.
"He lost his career, his reputation, his income, and his freedom for more than a year, with charges tacked on because of his insistence upon saving the life of a fellow inmate… which, by the way, has generated a New Jersey State Justice Department investigation.
"In addition, if this panel had not convened, he would have faced an even longer sentence for faking his own death to avoid parole revocation - which never would have been necessary if Dr. House hadn't saved that man's life, causing his sentence to be extended. Of course, that revocation is now moot because of Dr. Chase's admission."
"But… but…" said Cuddy, ineffectually. Why, after all these revelations, she still felt the need to respond so strongly, she didn't know. Habit, maybe?
"Dr. House actually behaved admirably under the circumstances. Yes, he has, in many ways been his own worst enemy, but he has also been a remarkably loyal friend to Dr. Wilson, acting as he did to share what they both believed to be Dr. Wilson's final few months, and then in returning to face this inquiry, even though he knew there would be severe legal consequences.
"As a panel, we have strongly recommended to the New Jersey State Corrections Department that no further incarceration be required, and, as we already noted, that his previous criminal record be expunged. In another unanimous decision, based on our medical findings, they have agreed with our assessment. We express our apologies to Dr. House. You are free, sir."
Cuddy's jaw snapped shut in shock. For his part, House again nodded his thanks, this time to the panel, before returning his gaze to the floor. He seemed to find a speck of dust there endlessly fascinating.
The panel chairman stared long and hard at Cuddy to see if another outburst was forthcoming. When it wasn't, he continued. "We know, Dr. Wilson, that it can't have been easy being friends with Greg House at times, and we admire you for staying friends with him for all these years. In many ways, you have been a good friend to him. Just because we asked you some difficult questions doesn't mean we are unaware of Dr. House's negative characteristics and behavior.
"However, Dr. Wilson, we find that some of your own behavior as described in these hearings has been fairly reprehensible, and we recommend that you be censured for the following actions and inactions:
For demeaning and repeatedly ignoring the pain issues of your patient;
For withholding pain medication or your medical services from that patient on more than one occasion;
For abandoning the same patient when he was suicidal and had overdosed on painkillers and alcohol, and for not seeking proper medical attention in that situation;
And primarily, for asking said patient, while already severely injured, to undergo a life-threatening procedure for no medical reason whatsoever, but simply to serve your own personal agenda.
"Dr. Wilson, we recommend that your medical license be suspended for a period of not less than two months and not more than six. You need to know that Dr. House has argued on your behalf, or otherwise that suspension would be considerably longer and our determination much harsher."
Wilson slumped forward in his chair. Somehow, he knew this was coming, but he felt unprepared for it. And then, to find out House had gone to bat for him, when he knew he hardly deserved it. He felt the air leave his lungs.
As the reality of his suspension sunk in, Wilson made up his mind. If House could face the virtual certainty of a long jail term just to spend a few precious months with him, then the very least he could do was accept this suspension with some semblance of grace. He sat up straighter in his chair, lifting his chin slightly as he responded to the panel's decision.
Clearing his throat, he addressed his inquisitors. "Thank you, Mr. Chairman, and ladies and gentlemen of the panel. It's mortifying to admit that what you have said is true, that I have sometimes behaved shamefully, not just toward a patient, but to my best friend, someone who has repeatedly demonstrated through his actions how much I matter to him. I… I know I warrant much worse than this suspension, and I appreciate the panel's charity, as well as Dr. House's intervention on my behalf.
"This inquiry has been a wakeup call for me, both personally and professionally, not to make assumptions about my patients - or my friends. And I recognize that I will need to be diligent to make sure I don't ever again commit the sin of arrogance." He managed a small, tight smile, before looking away.
To his left, Wilson felt something bump him. Looking over, he saw House's right hand reaching out in Wilson's direction. As House - the man who had such problems with physical contact - clasped Wilson's forearm, squeezing lightly, the two exchanged glances, and Wilson could have sworn he saw empathy on House's face. It'll be all right, House seemed to be saying. It'll be all right.
Wilson felt a prickling sensation behind his eyes. Such an idiot, he thought. How could I have been so wrong all these years? Is anything he ever did to me deserving of how I've treated him? The terrible, condescending things I've said to this man… and look what he's done for me, time and again.
For her part, unfortunately, Cuddy was still mired in the sense of emptiness that had overcome her earlier. She felt stunned, drained. Over the couple of years since House had driven that car into her Princeton home, her resentment of House had grown. Bitterness had eaten away at her, consuming her soul as surely as the cancer she'd thought she had would have consumed her body. Twelve days earlier, when she first entered this room, she had been pissed that she'd had to come here, extremely pissed at having to testify, and, if she was honest with herself, part of her was still pissed off that House was here and had just been exonerated.
The chairman turned his attention to her. Looking up, Cuddy held her breath. The chickens were about to come home to roost, and she knew it. "Dr. Cuddy, we don't doubt that you were convinced that you were doing the right thing at the time, but the truth is that you have made some extremely bad choices, both as Dr. House's supervisor and as part of his healthcare team. We can't avoid the conclusion that you have done him much more harm than good."
"Based on testimony from a variety of witnesses, and from our interviews with you, it is our expert estimation that, from the time you authorized the initial surgery on Dr. House's leg, up through the moment when you filed charges against him after he drove into your home, you have committed numerous unethical acts.
"Among other things, you exploited his international reputation, underpaid him, manipulated him, forced him twice into undergoing abrupt, unnecessary and painful withdrawal from needed pain medication, intentionally caused him physical harm on more than one occasion, and overruled his actual medical treatment.
"As his supervisor, you abused and misused your authority over Dr. House, violated the Americans With Disabilities Act, violated HIPAA by disclosing Dr. House's psychiatric history, neglected the medical and psychological needs of a patient and employee, and fostered a toxic work environment for him.
"Although your behavior may not have met all of the standards for sexual harassment in the state of New Jersey, it nevertheless violated the rules for sexual relationships between employer and employee as set down in the Princeton University guidelines, and as such, it was ill-advised of you to get involved with Dr. House in the first place, to continue to attempt to supervise him once you became a couple, and extremely unethical to withhold sex to get him to do what you wanted him to do at work."
Realizing she hadn't breathed throughout this assessment, Cuddy attempted to draw in a breath, but the best she could get was a shallow inhale of air. Almost as if hypnotized, she found her eyes riveted to those of the chairman, her emotions roiling beneath the surface.
"We must say that it seems to us as if your behavior at best verged on sexual harassment, by virtue of the fact that you began a sexual relationship not only with an employee, but with an employee who was at that moment particularly vulnerable. You used your sexual relationship with Dr. House to manipulate the way he did his job, which can certainly be viewed as a form of sexual harassment.
"In addition, in the instance of the debridement surgery, you functioned without giving him informed consent about what you intended to do. Your actions contributed to the constant and excruciating pain he will live with for the rest of his life. Dr. House has paid dearly for knowing you, Dr. Cuddy."
Once her head cleared, Cuddy was appalled. Grasping for dear life to the image of herself that was shattering around her, she thought, How dare they! She was the consummate professional. As she opened her mouth to respond, the panel chair went on, not giving her a chance to speak.
"Given the circumstances, we have made the following decisions. We recommend that your medical license be permanently revoked, and we have faxed a letter outlining our concerns about past unethical conduct to the board of directors at the Philadelphia Mercy Hospital. We have reported your violation of HIPAA to our supervisors at the AMA Medical Review Board. According to a certified letter we received from them on Friday, you will be fined the maximum under the law, $1.5 million in damages, to be payable directly to Dr. House to recompense him for years of underpayment and abuse, and there will probably be legal consequences as well.
"But I'll lose my job!" she sputtered. "You'll destroy me!" Suddenly devastated, she couldn't figure out how, in one instant, her whole life could change in such a dramatic way.
"Frankly," said the panel chair, with a distinct lack of sympathy, "it's nothing less than you deserve, under the circumstances. Over a period of years, you have essentially destroyed Dr. House's life, caused him irreparable physical and emotional pain, helped to ruin his reputation, and left him in tatters.
"For the damage he did to your home, you have expected Dr. House to be held accountable, which he has been, to a greater degree than was legally necessary. It's not unreasonable to expect that you now be held accountable for the damage you have done to him. I would hope that you would behave as responsibly as Dr. House did."
Cuddy was horrified. In a million years, she never expected things to turn out like this. After all, House was the bad boy; she was the good girl.
The panel chair continued. "In addition, we have contacted the New Jersey Department of Children and Families, proposing that Dr. House be given visiting privileges to see your adopted daughter, Rachel, who clearly misses him, even after all this time. Based on our recommendation, they have reviewed the situation and agreed with our findings regarding regular visitation."
Shocked that, in addition to everything else, she might be forced to interact with House on a regular basis, she couldn't even find words for a moment. When she finally could speak, she muttered, "You can't do that!"
"Actually, we can and we did," said the chairman. "The Department's review board agreed with us that Dr. House had become a father figure to Rachel, and as such, should be allowed visitation rights."
Cuddy was literally speechless.
"Just as he did regarding Dr. Wilson," the chair went on, "Dr. House spoke to us on your behalf, asking that we be lenient, but it is the determination of this panel that his wishes in this matter be overridden. For many years now, you have behaved abominably toward this man, not just professionally, but personally. You have been unethical, manipulative and cruel. Honestly, you'll be lucky to stay out of jail yourself. Our judgment stands."
As Cuddy paled in reaction, the panel chair turned his head to face House, who barely glanced his way. His eyes were still on the floor. "Dr. House, it has been said of you that all you ever cared about was the puzzle - that you never cared about your patients or anyone else. Based on our interviews and the statements we received from your former patients, we know this to be untrue. You deserve better friends than you have had - in fact, if you take the time to look around, I think you will find you have many more good friends than you think you do.
"We have one last recommendation. If you decide to return to medicine, we strongly suggest you do so at another place of employment - one less toxic to you than Princeton-Plainsboro has been, and one where you don't have to carry all of this ugly baggage. Personally, we'd love to see you publish a textbook about diagnostics. With your skills, the world is open to you. You should be able to write your own ticket, and we recommend that you start by contacting some of your friends and former patients around the world. Try not to get in your own way.
"In fact, on a personal note, several of us here on the panel are willing to supply professional referrals to help you reestablish your medical career. We will also be delighted to write you letters of recommendation if you so desire.
"Start anew, Dr. House. We wish you well. This inquiry is adjourned."
The panel chair stood, followed by his colleagues, and walked around the long table to where Greg House still sat, seemingly in shock over the way his life had suddenly turned around. Suddenly, House was surrounded by some of those very friends - old and new - he never realized he had.
Across the room, Cuddy, who was just as stunned by the turn of events as House was, tried to catch her breath. How could things have gone so very wrong, she wondered. Standing, her hands shaking, she clutched her handbag and tried to keep her balance. Then, making up her mind, she walked slowly toward the group surrounding House.
As the others realized she was approaching, they silently parted, leaving a pathway to where he was seated.
"H-House?" she whispered, finding it hard to get even that one word out.
House lifted his head toward her, plainly confused and a bit apprehensive. As she looked down at him, Cuddy swallowed, and then mouthed the words she'd seldom voiced… and had never really meant before. "I'm so sorry, House," she said, overcome by a flood of feeling. "I really am."
Not saying a word in response, House nodded his acceptance of her apology, but Cuddy could see hurt and sadness in his eyes… because now, finally, she was really… really… seeing him. Not the image she had of him, not the imperfect boyfriend or the recalcitrant employee, but the man. Shaking her head regretfully, she turned and silently left the room, headed out to piece together the shambles she'd made of her life.
Five minutes later, the remaining group, still gathered around Greg House - now a free man with an unlimited future - led him out the door of the dark, muggy, stuffy room and into the brightly lit hall, where they convinced him to join them for a celebratory meal. The last one out the door was Wilson, who took a last look around, allowed himself a hint of a smile, and turned off the light.