Pain and Magic

House really hated it when they cornered him in the elevator. "Let me guess," he said, giving Alison Cameron a long-suffering look. "That's a patient's file you're holding in those well-manicured hands. And you want me to look at it."

"Isn't that what we do? We look at patients' files so that we can treat them?" She held out the folder, but it just lingered there in her grasp.

"I'd say that's fairly accurate, but you forgot one thing. I only treat patients whose cases fascinate me, because I'm that much of a bastard. Now, you have thirty seconds. Give me the spiel." The elevator doors opened and they both stepped out.

Cameron hesitated only briefly before launching into what seemed like a very well prepared speech. "He was brought in this morning by paramedics after some police officers found him in an alley, passed out. They originally thought he was drunk, but his blood alcohol and tox screen were normal. They were going to release him in the emergency room, but one of the doctors noticed some interesting symptoms and referred him to us. He seems to have difficulty walking but doesn't admit to any pain - "

"Macho," House snorted.

"Urinary incontinence."

"How old is he?"

"Appears to be in his fifties, though he hasn't exactly been forthcoming with our staff. The doctor also mentioned a great deal of... irritability."

House stopped walking. "Cameron," he said, "this is possibly the most boring case you have ever brought before me. A cranky old man with problems controlling his bladder and arthritis. Call in the frickin' cavalry."

"And he thinks he's a wizard."

House scrunched up his face. "What?"

"He thinks he's a wizard." Cameron held out the folder again.

House snatched it from her. "Okay. I'll admit it, you're getting better at this." With that, he limped away, one hand on his cane and the other clinging to the patient's file.

He could almost hear her triumphant smile behind him. How annoying.

***

Cameron, Chase, and Foreman had That Look on their faces when House walked into the conference room - the one that meant they'd been discussing something and had immediately shut up the moment they saw him coming.

"Okay, spit it out," he said, walking over to the white board and glaring down at them. "What is it this time? You can't still be using your precious gossip time to whine about what a mean, horrible boss I am."

"We were discussing the patient," Foreman replied carefully.

"Okay, fine, I'll pretend I believe you. Why don't you share your thoughts with the class, Dr. Foreman?"

"Well, for one thing, he keeps trying to leave. But he's having so much trouble walking that he'll get about to the door before he just starts cursing up a storm and climbs back into bed."

House scribbled 'difficulty walking' on the white board. "More specific?"

"Irregular gait," Cameron blurted. "An extremely pronounced limp. I'd assume it was caused by pain, but he says there's none and it would have to be a great deal for as much difficulty as he's having without another underlying cause. I've also noticed his hands shaking."

"Okay. What else? Dr. Chase, have you been to see our guest?"

"Yes." He didn't look terribly happy about this. "He also seems to be suffering from urinary incontinence, and put up one hell of a fight when we put in a catheter."

"A fight?"

"Well, not physical. Just cursing a lot and muttering about how he doesn't have his wand."

"Ah." House added 'urinary incontinence' to the list, and then said, "So that brings us to our next point, eh?"

"He thinks he's a bloody wizard," Chase snorted. "Dementia."

"I take it you don't like our patient very much, Dr. Chase."

"He's rude."

"Gosh, that's unusual. A rude person. Where's he from, Queens? Or another tofu-gobbling, mean-spirited hippie from California?"

"Actually," Foreman interrupted, "he's British."

House smirked. "Well, good to know that America doesn't have the market cornered on rudeness. So. Dr. Chase says it's dementia. Other opinions?"

"I have to agree with Chase," Cameron said, shrugging. "Not only the delusions, but the irritability. No one's that - " She stopped.

"Cranky? Gosh, Doctor, maybe I'm suffering from dementia." House feigned a thoughtful expression, then let it slide into rolled eyes and scribbled 'dementia'. "But you've got me on the delusions. So what do we think he's got?"

"Those are the classic symptoms of normal pressure hydrocephalus," Foreman said.

"Yes indeed. Let's wrap a bow around it and call it a day, shall we? So we think he has a build-up of cerebral spinal fluid." House tapped his cane on the table in front of Foreman. "One way to find out, right? Get to it before we waste our brain cells coming up with other solutions."

*****

Foreman inhaled deeply before walking back into the hospital room. "Nice to see you again, Mr. - Snape, is it?" He glanced down at the file in his hand again. "Severus? What an unusual name."

Before the bedridden man could reply, Chase stepped in behind Foreman, smirking. "Ah... is that your wizard name?"

The look he received in response probably could have toppled a small animal. "It is my name," the man snapped, "though if you insist on addressing me, you may call me Professor Snape."

"Certainly, Professor," Foreman said, glaring at Chase. Underneath the file, he was holding a clipboard, which he held out towards the bed. "After reviewing your case with our supervisor, we've determined that you most likely have a condition called normal pressure hydrocephalus. It involves an increase in cerebrospinal fluid - too much fluid in your head. So what we want to do is take a lumbar puncture, a spinal tap, to get some of that fluid out, and see if it relieves the symptoms."

Snape struggled a bit to sit up in bed, his pale, gangly arms sticking out of his hospital gown in an almost comical fashion. The dark tattoo on one of them stood out prominently. "As I've told you repeatedly, I do not have any symptoms, aside from some slight trouble walking which I assure you I can take care of myself if you would allow me to leave and retrieve my wand."

Foreman ignored the bit about the wand. "But coupled with the bladder issues, and the - " He stopped short of mentioning dementia. After all, if the man truly believed what he was saying...

"That issue as you call it, has nothing whatsoever to do with my walking. It is the side effect of a rather nasty curse I was on the receiving end of several years ago, and has been quite manageable with potions. That is, if I'm at home with my storeroom where I can brew my potions." Snape glared, his eyes darting from Foreman to Chase as if he couldn't decide whom he disliked more.

"It's not like we're keeping you here against your will," Chase piped in with a shrug. "If you were able to walk out on your own then you could. Er, find your wand or whatever."

Snape grunted.

"Right then." Foreman shoved the clipboard towards him again. "So we think we should do that spinal tap. If it doesn't help, it'll rule out NPH and we can keep looking. We'll need your consent, though."

Snape snatched the clipboard and scanned it. "You want to stick a needle in my spine? What is this, the bloody Spanish Inquisition?"

"I assure you, it's quite - "

"Look, you bloody twit of a Muggle, you can take your sodding needle and shove it straight up your - "

"We'll discuss this with our supervisor," Foreman blurted, and practically dragged Chase out of the room.

*****

"What did he call us?" Chase was grumbling. "Muggles? Is that some sort of insult? That sounds like an insult. A British thing?"

"Why are you looking at me?" Foreman snapped. "You're the one with the funny accent."

"We'll discuss it with our supervisor? God, Foreman, get a spine - "

"Oh, how I love the sounds of bickering in the morning," House said, walking into the office. He stopped beside the pair and peered at them. "Let's get Cameron in here. And maybe a mud pit."

Foreman ignored him and said, "The patient won't consent to a lumbar puncture."

"Did you explain to him what it is? Oh, right. That's usually why patients don't want it."

"Did you want me to lie? Tell him it's perfectly painless?"

"Only if he asks."

"There's a reason it's called informed consent," Chase interrupted.

"Oh, gosh. Thanks for reminding me, Dr. Chase. It's been so long since that all important ethics course in med school. Besides, the man thinks he's a wizard. How informed do you really think he can be?"

"Are you suggesting we rule him incompetent?" Foreman asked.

"Maybe." House looked thoughtful. "Guess there's only one way to find out. I should talk to him." He leaned on his cane and started out of the room.

Foreman and Chase watched him go, and then both immediately stood.

"This, I've got to see," Chase said.

*****

"Hi, I'm Dr. House. And you must be Mr. Snape."

"Professor Snape."

"Professor of what? Magic? I hear you like magic." House grinned and pulled a chair over so that he was sitting right by the bed.

"If I hadn't been ill, I would have kept my sodding mouth shut," Snape grumbled. "As it is, when I get my wand back, none of you will remember a thing about this encounter."

"Is that so? Is this a selective ability? Because there are some things that I'd really like to forget. I could pay you."

Snape just glared.

"So. I understand you don't want our lumbar puncture." House pulled out Snape's file and started flipping through it. "Which means we don't know if it's NPH, which means we can't treat it. Which means you won't get better. Which means - " He looked up from the chart. "You might die. Think you'll get your wand back in Heaven? Is there magic in Heaven, or is it reserved for mere mortals like yourself?"

"I'm not having the test," Snape said through gritted teeth, "because I don't have the bloody illness. You don't believe me when I tell you I don't have the symptoms."

"Want to get up and try to walk? Prove me wrong?"

"The walking thing is the only symptom. Don't tell me that this NPH is the only thing that could cause that."

"Well, there's also the bladder control..."

"Which I told your little minions has nothing to do with anything else. It has to do with a bloody hex, which I can easily control with potions, when I have access to them, which I don't have at this bloody hospital!"

"A hex, huh? Someone hexed you to pee your pants?" House had the sudden feeling that if Snape weren't connected to all sorts of IVs and tubes that he would be strangling him right about now.

"I often keep poor company," Snape grumbled. "Humiliation is sometimes more interesting to them than pain."

"And pain? Did they hex your leg to hurt, too?"

"I told you I'm not in pain. They did throw a very... painful curse at me, right before they left me in that alley. But the effects are only temporary. I must have passed out from it, but when I woke up here, I was fine."

"Except for the trouble walking thing."

"Yes. Except for that. Which I imagine I can also cure with potions - which I assure you are immeasurably more advanced than your methods - if I could just get my wand and get out of here."

House looked at him for a moment. "Of course, there's the third symptom."

"Which is?" Snape snarled.

"Dementia."

Snape let out a string of expletives, then took a breath, looking at House as if he were a small bug to be squashed. "So just because you're a bloody Muggle who doesn't believe in magic, I'm demented. Well, that's fantastic. Just fan-freaking-tastic. I suppose you're going to treat me for the wrong illness and kill me in the process now?"

"So you think I should just take your word for it. On the wizard thing. And the hex thing."

"I don't bloody care what you do. But I'm not lying to you."

"Patients always lie."

"I don't," Snape spat, turning his head away. "You're not worth my time."

House seemed to consider that for a moment. "This curse. The one that causes you pain. How much pain?"

Snape looked back at him, briefly. "More than you could possibly imagine."

*****

When Cameron, Chase, and Foreman filed into the conference room, House was already standing at the white board with a marker. He immediately crossed off "dementia", and then after a moment's hesitation, "urinary incontinence" as well.

"What are you doing?" Chase asked incredulously.

"Let's play a hypothetical for a moment," House said. "Let's say he's not crazy. What are some causes of irregular gait not connected to the other two?"

"Woah." Foreman held up a hand. "What do you mean, what if he's not crazy? He thinks he's a wizard. He's flipped out."

"Flipped out? Is that a medical term, Dr. Foreman?"

"There are lots of things that could cause irregular gait," Cameron interrupted. Chase and Foreman both turned to look at her like she was crazy. "But he doesn't report any pain."

"Okay, well, the pain is the one thing I don't believe him on," House said, circling "difficulty walking" on the whiteboard. "Or rather, I think he just doesn't know he's in pain."

"How could he not know?" Chase asked.

House picked up his cane and slammed it against his own leg, without even wincing.

"What are you doing!" Cameron cried, obviously concerned.

"See that? That didn't hurt." House looked down at her. "Now, if I did it to you, it would hurt. Why?"

She sighed and slumped down in her chair. "Because I haven't experienced the kind of pain you have. After you break your foot, stubbing your toe is nothing."

"Exactly."

"And you think that he's experienced that kind of pain?"

"Nope. I think he's experienced worse."

"Then..." Cameron glanced down at House's leg. "You think it might be a DBT."

"Do a venography," House said, setting down the marker. "Don't need a consent for that."

*****

"We injected a special kind of dye into your veins," Chase said, helping Foreman position Snape on the X-ray table. "Now, when we take an X-ray we'll be able to see where it goes, and if it stops somewhere it's not supposed to, we'll know there's blockage."

"I liked the other doctor better," Snape grumbled.

Foreman lifted an eyebrow. "Doctor House? That's... unusual."

"I hate do-gooders." Snape snorted. "At least he's honest about his loathing."

Foreman and Chase exchanged a look before going back behind the X-ray machine.

"I think it's a match made in hell," Chase said.

"I'll make out the wedding invitations," Foreman added.

Cameron, who'd been waiting for them, didn't even crack a smile.

*****

"Let me get this straight," Wilson said, as he watched House examine an X-ray. "You actually believed this guy when he said he was a wizard? You don't believe anyone, and now this? Are you insane?"

"I've heard that, yes." House peered a spot on the X-ray. "But better to be insane than to be wrong. CHASE!"

Chase, who had been walking by, scurried into the room. "What?"

"I have an assignment for you." House slipped the X-ray back into its folder. "Find the paramedics who brought in the nutty professor, and find out where they brought him from. Then go there."

"And do what? Look for his magic wand?"

House just looked at him.

"You've got to be kidding me. Are you - are you serious? What am I supposed to even be looking for?"

House shrugged. "I'd ask our patient for a description. Probably something like - ten inches long, made of wood?"

Chase looked like he was about to say something, but then just sighed and left.

Wilson shook his head, amused. "You're always full of surprises."

*****

"So you... think there's something wrong with my leg?" Snape regarded House warily.

"No. I know there's something wrong with your leg. Know what it is, too. Want to hear?"

Snape glared.

"Okay, then. It's called a deep vein thrombosis, and that means there was a blood clot in your leg. Hurts like hell, usually, but I think you just don't care."

"I told you - "

"It doesn't hurt. Yeah, whatever. Here's my theory. I think it occurred at the same time as this hex thing that you describe as so excruciating - "

"That's an accurate adjective."

"... that when it was over, you didn't even notice the pain in your leg. Either that or you're playing macho because you like me. Should I act all demure and be impressed by the big, strong man?"

Snape ignored that. "But you think you can fix it? So I can get out of here and go home?"

"Yes, I think we've caught it early enough to do just that." House's expression soured. "Sometimes people aren't so lucky."

Snape motioned to his leg. "Is that how you know it hurts like hell?"

"Yeah. Quite frankly, based on experience, I can't believe I'm buying the whole 'no pain' thing."

Snape's eyes glazed over a little. "Be glad you don't understand."

*****

Chase did manage to find the wand (or "goddamned piece of bark" as he called it), and after the anticoagulants helped dissolve the clot in Snape's leg, he only had to stay for a few days before he was pronounced well enough to go home, albeit with a cane. House thought about asking if those potions of his were going to cure the permanent limp, too, but decided he didn't want to know the answer, whether he'd believe it or not.

Foreman and Chase were still disgusted by the whole case, convinced that they hadn't really treated him. "Sure, we fixed his leg," he heard Chase venting in the doctor's lounge, "but what about the other two symptoms? Just because House got all weird and crossed them off the board doesn't mean they're gone. The man is obviously crazy and we're just letting him roam the streets!"

House wondered if Chase was talking about Snape, or about him.

He'd nearly forgotten about the case when, a couple of weeks later, an owl flew into his apartment window. He was about to beat it with his cane, when the damned thing squawked and dropped a package on his bed before flying out the window.

He immediately checked his bottle of Vicodin to make sure he hadn't accidentally overdosed. Then he walked cautiously over to his bed and picked up the package, turning it over in his hands before peeling off the paper.

There was a note attached to a small vial of amber-colored liquid.

Dr. House -

I don't care much for Muggles, and I especially don't care for your primitive medical techniques. However, I am convinced that you did something to help me. My potions could have accomplished the same end result as your medications, but I would not have known which ones to brew. There is something to be said, I suppose, for your role as a diagnostician.

I no longer have a limp, because the pain (which I have always thought was minimal) is gone. I have enclosed a vial of the potion used to accomplish this. It is one dose, and it is permanent. I am not sure that I really expect you to drink it, but the least I could do was make the effort. I imagine you are just as stubborn as I am.

You may wonder why I did not erase memories as I promised. Since you were the only one who believed me, I saw no need. Especially since I still don't think that you really did. But I suppose if I ever see you with a limp, I will know.

Sincerely,

Severus Snape

*****

He took sugar pills for a while, so that no one noticed he'd gone off the Vicodin. After months of careful manipulations, he managed to convince everyone - including Wilson - that he'd weaned himself off of it.

And after even longer, the limp that he'd been faking became gradually and gradually less pronounced, until it completely disappeared.

He still didn't believe his patients. But he did believe in magic.