A particularly trying patient provokes House’s usual lack of sympathy for religious beliefs. His team are willing to follow House's lead, but Chase feels free to disagree.
Warnings: Written during season four, and thus may contain spoilers for any episode up to and including 4.14.
Martyrdom has always been a proof of the intensity, never of the correctness of a belief. ~Napoleon Bonaparte
Chase frowned down at the patient's chart, slightly embarrassed at having been put in the unfair position of being blamed for House's Kuru diagnosis--a diagnosis he'd never even supported, he thought, annoyed. "How long have you had a heart murmur?" he asked, changing the subject.
Selvaggio snorted. "Is that even my chart?" he asked. "I've never had a heart murmur."
"Says here that when they sent you upstairs from emerge the admitting doctor reported a heart murmur," Chase argued cheerfully, reaching for his stethoscope. "Let's have a listen."
"Infective endocarditis," Chase said triumphantly, pushing open the door to Diagnostics. "I've ordered multiple blood cultures to confirm, but it explains everything."
"Well, that was boring," House said, and erased the whiteboard. "The next time you encounter a ranting religious freak, keep him to yourself, will you?"
"He's not a freak," Chase said, sighing. "He's religious. The one thing doesn't imply the other."
"Chase," House called out the next day, and Chase slowed and entered House's office, his movements more languid and casual--and hence even more damnably graceful--than they'd ever been when his own pragmatism had demanded a show of obedience. House noticed the nonchalance, the complete and utter erasure of what had seemed to be an ingrained need to gratify, and found himself bemused by the near-sociopathic levels of cynical practicality implied by this. Annoying. It was always satisfying to have at least one minor stumbling block at hand to toss in front of Chase's easy stride through life.
"Selvaggio's blood cultures are all coming back negative for Streptococcus sanguis ," House said, sounding pleased. "So the endocarditis could be the result of any number of things, really: Staph. aureus , or something viral...you'll have to test him for--"
"Staph. ," Chase interrupted, groaning. He looked as if he'd just realized something both unpleasant and obvious. House gave him a sceptical look.
"Well, yes, it could be, but--" he began, but Chase had already turned and left his office, walking briskly. Shrugging, House picked up his cane and followed him.
"Mr. Selvaggio," Chase said, "after your trip to the Philippines, did you get sick? I mean immediately afterwards. Any nausea, vomiting, diarrhea? Maybe a rash?"
Selvaggio looked at him suspiciously. "I did, yes," he said, "and I was on antibiotics for ten days, and it cleared up. Why? Who are you accusing me of eating now?"
"Nobody," Chase said, sounding calm and slightly distant. The automatic tone and cadence of doctor-speak had entered, or perhaps been deliberately inserted into, his voice: that odd blend of reassurance and slight coolness. "But I believe your symptoms are the result of a bacterial infection. The antibiotics you were given may have had a bacteriostatic effect, but not have killed off all the organisms; the ones remaining have infected your heart valves." The patient looked alarmed; Chase's voice became more soothing, but it was a professional, rehearsed sort of soothing; that careful distance remained. "If the tests come back positive, you're going to have to be on Flucox for at least six weeks, and Gentamicin for five days, but the prognosis is good: your cardiac rhythm is normal, and your white count is near-normal, and those are both excellent predictors of recovery."
"Why are you thinking Staph. ?" House interrupted quietly from the doorway.
Chase hesitated, looking extremely reluctant to speak. "Because he spent Easter in the Philippines," he admitted finally, "and I suspect he may have obtained a major skin breaching injury there." That was all he said, but House was already smirking in satisfaction.
"Really ?" he said, mockingly. "I wonder why?" Chase didn't reply. "Mr. Selvaggio," House said politely, a smile twitching the corner of his lips, "would you mind if I take a look at your back?" Glaring wordlessly, Selvaggio leaned forward and pulled off the top of his pyjamas. Chase looked once, and averted his eyes. The stripes of flagellation, healed but still raised and red, were undeniable--and unanswerable.
References, for those who like to read about unusual disease vectors:
1. 100 men exposed to rabies virus in Easter flagellation ritual: http://www.canada.com/vancouversun/news/story.html?id=e6b0fc54-1200-40ed-8c22-5b22bf4b81ce
2. Easter penitents warned: Whip at your own peril: http://www.cnn.com/2008/WORLD/asiapcf/03/19/easter.whipping/index.html?iref=mpstoryview