A medicine, of course!
In the day-to-day life as a paramedic, there are dozens of emergency calls involving medications. An ordinary person will take any medication prescribed by a doctor without thinking twice. However, if there's a mistake and you accidentally take medication to treat something you don't have, it can cause an overdose that affects your body. This may not be immediate, but if your symptoms don't improve over time, you might continue taking the medication until it takes effect, whether for better or worse.
Quickly taking the muscle relaxant medication, I turned off the lights to walk swiftly to my room, where I covered the top of my still somewhat cold body.
With the help of a handheld flashlight, I took the pharmaceutical encyclopedia that House had given me to study, carrying it with me to my bed. Satisfied with the blankets over my body, I began to reread from the beginning, paying special attention to the overdose warnings for each medication.
I needed a medication that would cause fever and a rash on the body. I could ignore abdominal pain, nausea, and blood pressure not responding to IV fluids, as they were all symptoms of kidney failure.
Obviously, the cough started it all. The patient, being sick, went to the doctor, who, identifying a patient resembling the 'type one' from House's category, simply prescribed cough medicine. Later, at the pharmacy or before it, there was an error, leading to administering the patient a wrong medication from the prescription.
The question was, which one is capable of doing that?
Flipping through the pages and reading carefully, I came to what could possibly be my answer.
"Colchicine," I read aloud, fearing to wake Gabe, who was peacefully asleep in his bed.
It is a medication primarily used to treat gout, a type of arthritis caused by uric acid crystals accumulating in the joints, leading to inflammation and pain. It is also sometimes prescribed for other conditions, such as familial Mediterranean fever and pericarditis.
"The colchicine blocks mitosis and stops cell division, resulting in abdominal pain, rash, fever, nausea, low blood pressure, kidney failure, and messing with the bone marrow," I read more confidently, convinced that this had to be the answer. A simple error explained why the order of symptoms seemed so strange; the patient was self-inflicting them.
"What's going on?" I heard from Gabe's bed with a tired nasal tone. "Is it time to run?" he asked, lifting his head still half asleep.
"No, buddy, sleep," I quickly replied, turning off the flashlight, causing him to lower his head again and immediately fall into a deep sleep.
Amused by how easily Gabe could sleep, I closed the corner of the page, shutting the book to leave it on my bedside table along with the flashlight. I had to investigate a bit more, but it was a good start to a theory.
Still thinking about the implications and treatment for colchicine overdose, I closed my eyes peacefully to sleep.
As usual, I managed to wake up a few moments before the alarm clock, turning it off to avoid it ringing. I woke up Gabe to get both of us ready for our morning run.
After warming up and stretching in the front yard, we started our run around the neighborhood. For the season, it seemed like the sun was rising a bit later, and coupled with the cooler temperature, the atmosphere was much chillier. Despite that, the streets of our neighborhood had the same amount of life as every past day—people walking their pets, other runners, mail carriers, delivery persons, and people heading to their cars to go to work.
Without really thinking about it, I counted the last lap of my usual runs. "Look at that, you did the same number of laps as me," I told Gabe, who was bent over, hands on his knees, panting for air. Gabe could only raise his thumb over his still bowed head in response.
"Breathe," I said, placing my hand on his back. "Give it a few more days, and you'll be able to do it without any problems. Let's go," I continued playfully, giving my brother a slight push on his shoulder.
"Yeah," said Gabe, quickly straightening up to avoid stumbling, then swiftly returning to try to push me back.
Dodging the little kid's attempt, I entered the house quickly, with him following behind me.
"Gabe, there you are," Mom said as we entered the kitchen to each grab a glass of water. "He accompanied me during my entire run," I explained to the woman after drinking the water, making her smile in surprise at her younger son. "Look at that," she continued proudly, embarrassing the little boy.
Shaking the boy's head, "Go clean up in Mom and Dad's bathroom," I ordered as I lightly pushed him out of the kitchen.
Leaving my glass in the sink to be washed, I left the kitchen to take a quick shower before going to school.
After cleaning up and grabbing my things from my room, I went to the kitchen, where I had a quick breakfast. A few moments later, I left with Bob in his awful yellow truck.
Listening to Bob's favorite songs through the speakers of the truck, we arrived at school.
"Have a great day, champ," Bob said as he lightly pushed me out of the truck, moving to the rhythm of one of the songs.
After saying goodbye to Bob, I entered the school, greeting some of my classmates I crossed paths with as I walked towards the door.
Walking through the school hallways, returning the greetings to anyone who greeted me, and trying to ignore people who just pointed at me, whispering what was probably a highly distorted story of what happened in the cafeteria a few days ago. Unable to avoid it, I bumped into someone's shoulder, causing a few notebooks to fall to the ground. "Oh, I'm sorry," I said, bending down to pick up the fallen items.
"Thanks," said the person, and as I lifted my head to return the belongings, I discovered it was Kat with a completely neutral expression. "Kat," I said in greeting, somewhat embarrassed, remembering the interruption from the day before.
Surprised, Kat lifted her gaze, furrowing her brow. Then she snatched her things from my hands, quickly getting up. As I stood up with her, intrigued by her strange behavior, before I could ask her the reason, she advanced quickly, angrily hitting my shoulder as she passed.
Without moving, confused by Kat's annoyed attitude, I watched her move swiftly through the people in the hallways. Strangely, like me, some people seemed especially interested in Kat, pointing at her, laughing, and whispering among themselves.
"Yo, doctor!" I heard someone shout behind me as they grabbed my shoulder abruptly, making me turn quickly. In front of me was an extremely large teenager with obvious overweight. "What do you think this is?" he asked loudly with a silly smile, showing me his forearm where a black patch was stuck. As he displayed it, he continuously smiled at a group of teenagers beside him.
"That's dirt, probably mud. Take a bath," I quickly responded, removing his hand from my shoulder, annoyed by his obvious attempt at a bad joke. I imitated Kat's previous action, hitting the teenager's shoulder as I walked to my locker.
As I walked, I could hear the teenager's companions making fun of him.
Thinking about what I could have done to bother Kat so much, I continued walking until I reached my locker, where my four friends were already cheerfully chatting.
"Hey," I greeted everyone as I opened my locker. "SuperStar," Brock said cheerfully as he friendly hit my shoulder.
"Is everything okay?" Alan asked, arms crossed in front of his body.
"Yeah," I said, still a bit upset about the issue with Kat and especially the overweight teenager's joke.
Closing my locker in front of my calm friend, "Forget it, just an idiot," I said much calmer.
"I know a lot of them," Alan joked with a small smile, pointing his gaze at our three friends.
Amused, I lightly hit his arm in feigned disagreement.
Incredibly, my gentle touch on his arm caused an immediate reaction. With a futile attempt to hide the pain, Alan quickly stepped back out of my reach.
"Wow, Alan, are you okay?" I asked, concerned.
"Yeah!" he quickly responded, trying to downplay the issue.
Before I could continue with my interrogation attempt, "PJ!" I heard Sheldon's high-pitched voice behind me.
Trying to warn my calm friend that the conversation wasn't over, a rather unsuccessful attempt since the focus of my warning was splendidly ignoring me.
"Sheldon," I greeted the boy with a nod that he imitated.
"Can we go to class now?" he asked hopefully. Sheldon's natural complexion was usually pale, but today, for some reason, the boy looked much paler and sicker than usual.
"Feeling okay, little buddy?" I asked, lightly touching his forehead to check if he had an abnormal temperature.
"Yeah, just a little tired," the boy assured.
"Didn't sleep well last night?" I calmly asked the little boy.
"Oh, no, no, definitely got the necessary hours for my body's development," he eloquently replied.
"Then you didn't have enough food for breakfast. Want some of my lunch?" I offered as I turned to take out my lunch bag.
"Oh no, I'm very young, and I have many things to accomplish," the boy asserted quickly, denying my offer.
"What do you mean?" I asked intrigued.
"He's afraid of food," Georgie responded, amused, standing a few steps away, making David, amazed by the idea, stare at the boy completely incredulous.
"Solid food is a health hazard," Sheldon felt the need to explain immediately, despite the incredulous looks from those in front of him.
"So you didn't eat anything this morning?" I asked, concerned for the little boy's health.
"Oh, yes, I had a banana shake with oats," the boy replied.
"Okay then," I said, somewhat relieved. "Do you guys have everything you need?" I asked my friends in general, receiving positive responses. "Well then, let's go," I said, urging the little boy to walk ahead of me, walking with my friends to our first period.
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Classes went on with the usual daily routine, even though Sheldon wasn't as active as usual. Apparently, he had enough energy to quickly answer the questions asked by the teachers, continuing our competition of responses.
When lunchtime arrived, my friends and I sat at the table Regina and her friends used as their own. After quickly scanning everyone in the cafeteria, I noticed Kat wasn't present, and Sheldon had only a small chocolate milk box and a tiny jelly in front of him.
Listening as my three more excited friends began talking about some current popular movie, "So, are you going to tell me what's going on with your arms?" I asked, leaning towards my friend much calmer.
With a deep sigh, Alan slightly shook his head. "It's just a training accident," he said quietly with a small smile, undoubtedly trying to make me not worry about what happened.
Before I could ask him what he meant by a 'training accident,' two slender arms wrapped around my neck, startling me with the suddenness of the situation. "Hey, handsome," Regina greeted as she sat next to me, pushing Alan gently, who quickly moved on his own, avoiding Regina's hand.
"You scared me," I joked with Regina when she finished settling into her seat, opening a salad bowl.
"Oh, I'm sorry," the girl responded, amused, pushing her shoulder against mine.
As Regina's two friends also took a seat at the shared table, each group of friends continued with their own conversations and lunches, at least for those who could easily eat. It was a bit challenging for me because Regina always had my arm trapped with hers.
After lunch, we continued with our last two periods to go to training where, like in the previous sessions, the coaches gave us a physical circuit to start, and we ended up running and practicing the plays we already knew.
"Hit the showers," Coach Cooper shouted after blowing his whistle loudly, allowing many of my teammates, myself included, to internally celebrate as we were all generally tired.
"PJ, come here," Coach Cooper shouted, separating me from my teammates. "Hello, son, I know this isn't your problem, but—" Mr. Cooper continued, placing his hand on my shoulder and making sure no one was around to hear, "it's about Sheldon. You know he's—" he paused abruptly, searching for the right word, "special," he said uncertainly about the use of the word, "but nothing like what's happening now. He's afraid of food," he confessed quickly, speaking as if the idea were completely unheard of, "so what I wanted to ask you, as you're my son's friend, and I know from his word that you're one of the few people he respects, maybe you can talk to him," Mr. Cooper asked hopefully.
"I heard it from Sheldon; don't worry about it, Mr. Cooper. Sometimes children of Sheldon's age, when they experience a traumatic event, may develop a minor phobia. But I'm sure he'll overcome it with time," I assured the man, trying to reassure him.
"That's exactly what I told Mary. Well, anyway, I'd appreciate it if you could talk to him," Mr. Cooper finished with a slight embarrassed smile.
"Of course, sir. I'll talk to Sheldon," I assured him calmly.
With a pat on the shoulder, Coach Cooper walked toward the locker room, with me a few steps behind him.
When we entered the locker room, to my unfortunate and unpleasant surprise, most of my teammates had already finished 'cleaning' their sweat in the showers. The lack of hygiene in teenagers never ceases to amaze me.
Separating from Mr. Cooper, I quickly went in to grab a towel and head to the showers, where a thick cloud of steam welcomed everyone who approached.
After cleaning my body, making sure to clean what needed cleaning, I emerged back into the locker room, where I was relatively alone. Grabbing my things from my locker, I started dressing quickly.
Once ready, I gathered my belongings to leave the locker room. However, in one of the locker aisles, I ran into Alan, who was quietly applying some ointment to his arms. Focusing on his arms, which until a few minutes ago during the entire training session and school duration were completely covered, I said, surprised, "Alan, what happened?" I asked, approaching the teenager to get a better look at his limbs.
Bruises covered his long, swollen arms.
"It's nothing," the usually calm teenager said, strangely hiding his arms under a towel quickly.
"Let me see; it's clearly something, idiot," I said, a bit annoyed. "What kind of training causes this?" I asked, holding one of his arms firmly, avoiding the large bruise.
With a hint of shame or annoyance, Alan kept his head down, muttering words I couldn't understand until one of them sounded like 'father.'
"Did your father do this?" I asked, surprised and upset.
I remembered his dad; the first time we saw him, Bob and I were outside Alan's house the day we dropped him off after the game. He was definitely a stoic and intimidating man. I didn't think he could be an abuser.
Not receiving a response from the teenager, I shook my head. "I'll tell Coach Cooper," I said, determined. I couldn't allow a man to physically abuse a teenager, especially one with two younger siblings.
"No!" Alan raised his voice faster, and before I could react, he freed his arm from my firm grip, quickly standing up from the locker room bench. In a series of apparently carefully measured movements, he pushed my left shoulder forcefully while lightly kicking my opposite foot before pulling my shirt and forcing one of my arms slightly behind my back. "It's not what you think, PJ. It's just a boxing training accident. My dad teaches me to box, and like an idiot, I thought the best way to improve my guard was by toughening my forearms, hitting a tree," he explained quickly, gradually controlling his tone.
Struggling a bit to free myself from his grip, it seemed Alan realized the position we were in. "Sorry," he immediately said, releasing my wrist, lifting his hands to his chest, and lowering his head in embarrassment.
"Hitting a tree?" I asked seriously, not going to mention the embarrassing incident where a teenager had defeated me before I could resist.
"I read that some Chinese martial artists did it to toughen their knuckles, and I thought I'd give it a try," the teenager explained calmly. "It was a bit embarrassing to admit," he continued, smiling almost imperceptibly.
Staring at the teenager, thinking about what to do and trying to intimidate him, obviously without result since his ability to immobilize me was something he knew how to do and not just a stroke of luck.
If what he says is true and it's just something a foolish teenager would do, I would be less worried. But something didn't feel right. I couldn't completely judge the man after only meeting him once, but without Alan speaking up, there was very little that could be done, especially in this era. I would only embarrass my friend and his family.
"If you're going through something, Alan, you can always come to me, and I promise I'll help you without exception. We're friends," I said, surrendering to the problem, trying to appear as serious as possible.
Being the calm teenager I knew, Alan simply nodded slightly with a hint of a smile on his face.
Patting my friend on the shoulder silently, I said goodbye.
"Thanks, PJ," I heard the boy say as I took a few steps.
"You're welcome," I replied. "By the way, stop hitting trees; they didn't do anything to you," I joked before leaving.
When I left school, mom was already on the main street in her car, cheerfully dancing and singing along to a song blasting from her car speakers, completely unaware that dozens of teenagers were watching her with amusement.
"PJ!" Mom greeted happily when I opened the car door.
"Hello," I greeted the woman as I got into the car, preparing to leave.
Even with the music blaring through the car speakers, we drove out of the school grounds.
After a few minutes of driving, once again thinking about my new problem with my friend, Mom asked, slightly concerned, lowering the volume of the music, "Are you okay, PJ?"
Surprised by her ability to sense my emotions, I quickly changed my face, smiling to try to reassure the worried woman.
"It's just a problem at school," I assured her calmly, making her nod slightly, not entirely sure, before turning up the music again.
After Mom parked the car outside the hospital in its usual spot, we entered, greeting Mom's nurse colleagues.
Having greeted all the friendly nurse colleagues of Mom, I headed to House's office to continue the investigation to prove my theory about the medications.
House's office was completely empty, which was usually not common to see.
Leaving my things on the office floor, I began searching through the books House had next to his desk for something that might be useful. Taking a book that could possibly help, I left the office and headed to the hospital library to find more information.
I needed to know why and how colchicine damaged the kidneys.
In the library, I found information on gout and its treatment with colchicine, confirming what I had already found the night before. Taking all the documents, I returned loaded with evidence to support my theory.
Unlike before, House was sitting in his office, bouncing his cane on the floor, staring fixedly at the words written on the board.
When I entered through the office door, House raised one of his eyebrows, silently asking what I had in my hands.
"Hello, I have a theory about what might be happening to the patient," I asserted as I placed the documents on his desk.
Turning his chair to face me, House raised his eyebrows incredulously, giving a sarcastic smile. "Enlighten me," he said sarcastically.
"Gout," I affirmed, amused, as I leaned in to grab the book he had handed me earlier.
Chuckling, House leaned back in his chair. "I don't think a teenager a few years older than you has uric acid crystals in the joints, kid," he commented sarcastically, still taking the book I offered and opening it to the marked page.
"Exactly, so why is he taking medication to treat it?" I asked as I walked to the board, grabbing a marker. "Colchicine," I said, writing the word at the top. "It blocks mitosis and stops cell division," I explained to the man who was reading the book in his hands, with a small growing smile on his face. "Which will result in abdominal pain, rash, nausea, fever, kidney failure, low blood pressure," I continued quickly, crossing out each symptom on the board.
"And it will also mess with the bone marrow," House added as he closed the book in his hands.
"Yeah, you were wrong. There weren't two symptoms, just one – the cough," I said sarcastically to the bitter doctor.
"Some idiot made a mistake, and because of a cough, they caused kidney failure," House said, laughing lightly as he shook his head slightly. "I knew it," he affirmed, amused, as he stood up.
"So, did we reach the same conclusion?" I asked, proud of myself.
"No, I knew it would be fun having you around," the man stated with a big amused smile. "Let's go," he said, exiting the office.
Following House, I said, "In theory, with the treatments you applied yesterday, the patient should be better."
"Yes, that's true, but last night he had a relapse, and Foreman did a study of his white cell count; suddenly, it was very low," House explained.
"His immune system was compromised," I affirmed, quickly understanding.
"Yes, they admitted him to a clean room," House continued, frowning. "So, how does that work with your theory?" he asked, smiling strangely at me.
"A type four," I said disappointedly.
"Yes, we didn't administer anything for the cough; someone must have done it. Come in," he said, pointing to a laboratory door.
In the laboratory, the other three doctors who work with House seemed tired as they read books completely focused.
When House entered, he caught the attention of the other three doctors present. "Gout," he affirmed, imitating the tone in which I had said it, obviously mocking me.
Greetings to Dr. Cameron and Chase, we paid attention to Foreman, who sighed and stood up.
"Um, are we talking about Brandon?" Chase asked.
"Gout?" Foreman asked, frowning. "Uric acid crystals in the joints? The symptoms are pain, swelling, redness, stiffness... not one of which is on the board."
"Because he doesn't have gout," House responded with obviousness, leaning against one of the walls and closing his eyes with a proud smile on his face.
"Okay, so why mention it?" Foreman asked annoyed. After a few seconds without House's response, tired Foreman spoke again, "Aren't you going to tell us?"
Opening his eyes with a surprised expression, Dr. House smiled even more arrogantly. "It's not my diagnosis, kid," he ordered, making the other three doctors focus their attention on me, two of them much more interested than the other.
Nodding to House, I quickly explained to the three doctors what I had already explained to House.
"But he doesn't have gout," Chase said, denying. "Why would he have gout medication?" he asked calmly, leaning back in his chair.
"Yeah, your idea also doesn't explain the cough," Foreman quickly added in a neutral tone.
"Because you guys were right," explained House, separating from the wall. "He didn't have two conditions at the exact same time," he continued, smiling slightly with defeat, rolling his eyes for admitting he was wrong.
"The cough is the only natural symptom," I said, making the doctors tilt their heads, still not understanding.
"He's an idiot," affirmed House, "he went to a doctor, who, to feel justified in charging two hundred dollars, felt the need to do something in reality," House mocked, "so whoops, he made a prescription."
"Almost six thousand people die each year from pharmaceutical errors," I added.
"Not nearly as many as die from doctor screw-ups, but still, not something they use in their promotional material," House added amusedly. "The pharmacist gave him gout medicine instead of cough medicine," House resolved, making the doctors understand. "And the only thing it wouldn't do: it would do absolutely nothing to relieve his cough," he continued amusedly. "Occam's Razor," he said to Foreman haughtily. "The simplest explanation is almost always somebody is an idiot."
"But once he checked into this hospital, he was completely in our control," Cameron countered, theorizing. "Our food, our pills, our everything," she continued seriously. "So even if you're right, no gout medication," she told me with a kind smile. "He'd either continue to deteriorate or he would have gotten better," she continued with a bit of disappointment. "But he got better, and then he got worse. It doesn't fit; it doesn't make sense."
"So even better, two idiots at different times," said House, leaving the laboratory.
Foreman was the first to exit behind him. As he passed by me, he simply looked at me for a few seconds before leaving through the door.
"Well done," Chase said, patting my shoulder kindly before also leaving through the door.
"Impressive," Cameron nodded, also leaving behind the others.
---
Author Thoughts:
As always, I am not American, and certainly not a doctor.
I love remakes :D (Resident Evil 4 remake is ART)
I was accused on one of the pages where I upload the novel of being a marketing agent for vaccination. I wish!!! At least I would earn some money doing this hobby. If you don't want to get vaccinated, I respect your ability to decide for yourself, but I don't respect your decision. For me, vaccination and modern medicine are a duty, not an option.
Having said that.
I think that's all. As always, if you find any errors, let me know, and I'll correct them immediately.
Thanks for reading :D
PS: LEAVE A REVIEW, please.
PS2: The next chapter is closer than it seems ;D VACATION!!!!!