Chapter 7: Lucky? No, It's Professional
Facing Foreman, who was lecturing him like some old-school attending, David smiled dismissively.
That smile clearly pissed Foreman off even more.
Foreman stared at David with barely concealed hostility:
"What? Did I say something you found amusing?"
Meeting Foreman's aggressive stare, David calmly held his gaze and spoke evenly:
"Of course it's amusing. Medicine isn't a profession where you can rely on luck for diagnosis.
That's irresponsible to the patient and a complete denial of your professional training.
The goddess of luck has never smiled on me because I don't need her to. Everything I do is based on clinical judgment and evidence.
And speaking of evidence, I can actually answer your earlier question.
How to make the patient believe she has tapeworms in her brain."
Foreman scoffed, clearly skeptical that this intern could come up with any viable solution.
After all, if a method eluded a Johns Hopkins graduate like himself, how could some first-year intern figure it out?
"Alright, I'm all ears.
But if you can't back this up with something concrete, don't be surprised when I add a note about academic dishonesty to your evaluation."
David chuckled softly, finding Foreman's threat about his file incredibly juvenile.
He didn't give a damn about intern evaluations. All he cared about was whether he could save lives!
"As we all know, the density of cysticercosis larvae is nearly identical to cerebrospinal fluid, which is why standard brain CT scans can't visualize the parasites.
That's also why we didn't find them in the initial workup.
But here's the thing—the part of the human body that tapeworms love most isn't actually the brain. It's skeletal muscle, particularly in the thighs!
Just because we can't find evidence of parasites in the brain doesn't mean we can't find them elsewhere in her body!
So if Rebecca has neurocysticercosis, there will inevitably be calcified larvae in her thigh muscles.
CT might not show them in the brain, but there's a very common imaging study that can detect them perfectly—a plain X-ray!
Moreover, a thigh X-ray is completely non-invasive and absolutely safe.
Even a patient who's already given up on treatment won't object to something that simple.
Therefore, we don't need to fabricate consent or apply for a court-ordered guardianship to force treatment."
Hearing David lay this out, everyone felt like fog had suddenly lifted.
The logic was sound, but somehow they'd all suffered from cognitive tunnel vision, subconsciously overlooking this possibility.
They'd been so focused on finding proof in the brain that none of them had considered that thigh X-rays could provide confirmation of a brain infection.
But when David explained it, everyone instantly understood the approach was not only feasible but brilliant—including Foreman, who'd been so skeptical moments before.
He genuinely hadn't expected David to identify a real solution from such an unconventional angle.
As a result, his previous assumption about House failing to convince the patient, then fabricating unconsciousness to justify forced treatment, now seemed like complete clown behavior.
Thinking about it that way, Foreman felt even worse, his expression looking like he'd just swallowed a fly.
He'd deliberately lectured David loudly, wanting Cameron to see through this intern's supposed incompetence.
Instead, the situation had reversed in seconds, making him look like an idiot.
Foreman's mood now was the same as when he'd been caught and sent to juvie at sixteen—wanting nothing more than to escape.
If House hadn't still been in with the patient, he would've found any excuse to get the hell out of there.
Meanwhile, Cameron looked at David with genuine surprise.
To think of a proof method that quickly, within the brief time Foreman had proposed his hypothetical scenario?
This intern's mind worked at an incredible speed.
Cameron couldn't help but study David's sharp features again.
In just one day, this intern had given her far too many surprises.
Why had she never noticed this guy before?
Chase, who'd remained silent throughout, now had a completely revised assessment of the intern who'd cost him ten bucks.
This guy David had meticulous reasoning, extensive knowledge, strong practical skills, and no obvious weaknesses had emerged yet.
This nearly comprehensive competency really didn't match the profile of an ordinary intern.
Anyone who continued viewing him as just another first-year would eventually be proven wrong.
David might be young, but that didn't mean he was incapable.
On the contrary, he was exceptionally professional.
Based on today's performance alone, David was fully qualified to join Diagnostic Medicine as a fellow after completing his residency.
At the same time, Chase saw echoes of someone else in David—a shadow of House before his leg infarction.
Equally young, equally gifted.
The only question was whether this was a flash-in-the-pan performance because David happened to stumble into a case he was familiar with, or whether he truly had this level of substance consistently.
For a moment, everyone fell silent.
In that strange quiet, the glass door of the ICU opened.
House's appearance broke the awkward atmosphere.
Especially Foreman, who'd been desperate to leave, was the first to address House:
"So? Did she agree to treatment?"
House shook his head with obvious frustration:
"She refused."
The group exchanged glances, not expecting the hypothesis to actually come true.
Cameron, hearing the note of resignation in House's tone, immediately pushed back:
"So we're just going to stand here and watch her die?"
House was quiet for a moment, then turned with his cane and started walking out:
"I made my diagnosis. Whether she believes it or not is her choice.
I respect her decision, even if it's choosing death. It's not my problem anymore."
House, limping down the hallway, paused and couldn't help adding:
"Patients always want me to give them absolute proof, but how many things in this world come with 100% certainty?
We're not underwriting insurance policies here. I can't always provide collateral for my diagnoses."
Seeing House about to leave, Cameron glanced at David and immediately called out:
"Wait! What if there's still a way to make her accept treatment?"
House's steps stopped abruptly. He turned his head:
"Oh? You have something brilliant up your sleeve?"
Cameron immediately repeated David's solution:
"Thigh X-ray. To prove the parasites are in her body."
House stood motionless, thinking for a moment, then his eyes suddenly lit up:
"You're right—we can do an X-ray. The worms love muscle tissue!
CT can't visualize the larvae, but plain films can show calcifications!
Nice work, Cameron!"
Cameron, receiving House's rare praise, looked embarrassed and immediately corrected him:
"This wasn't my idea. It was David's solution when we were discussing the hypothetical scenario."
David?
That intern?
House looked at David standing nearby. This kid could handle procedures, clinic duty, and differential diagnosis.
As expected from an excellent medical school graduate with strong recommendations.
Much better than the mediocre interns they'd been stuck with in the past.
But the only problem was that this guy was way too confident.
The way he presented his conclusions had an air of absolute certainty that didn't invite questioning.
Sure, the facts had proven David right so far, but what about next time?
In this profession, mistakes cost lives!
He needed to find a way to knock some humility into this cocky intern.
"Good work. I'll take Rebecca down for the X-ray, and you can cover my clinic hours."
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