Disclaimer : I, of course, own no rights to House M.D. or any of its characters. This derivative work was created solely for enjoyment and is not connected to, or endorsed by, the show's creator, writers, or copyright holders.

Warnings : Major Character Death

Introductory Notes:

"Almost Perfect" is my take on what I think would have been a more believable departure for Cuddy, if she had to leave. I apologise in advance to Huddy fans looking for something entirely light and fluffy. I'm a fan of Huddy, myself, but when writing, I gravitate towards "partial" fix-its and the bittersweet, which is what this story is. So, if you're not in the mood for something that deals with life and death, and delves into a bit of darkness, you may prefer to pass. But I promise it's not all doom and gloom. There are smiles and lighter themes, as well, and I don't think the ending will disappoint.

The story follows a canon divergent plotline which spans the final eight episodes of season 7. Canon events and cases form a backdrop to the new material. The actual time frame has been altered to fit the storyline's pacing. Chapter titles come from the episode titles.

One noteworthy change which is not explained within the scope of the story is that in this "universe" Taub never returned to the team, while Cameron remained after the incident with the African dictator. I may write a brief tie-in at some point which properly explores that.

Chapter 1

Out Of The Chute

8 March, 2011

Her eyes roll beneath their lids as the anaesthesia wears off. The words are circling my mind, making their way to my lips, but they're not the right ones. The truth is easy, but delivering it to her isn't. It has to be cushioned. It has to be coated with some flavour of sweetener that's supposed to prove I care.

"House?" She lifts her head from the pillow and reaches for my hand.

I offer it. Her fingers are clammy. The shapes passing outside the room, visible through the gaps in the blinds, pull my focus. But not really. More like give me something to face instead of her eyes probing mine for an answer.

"What is it?" she asks.

"I'm sorry," is all I can force out, shifting the rosewood cane beside my chair. "I was wrong."

She pulls herself up in bed and stares unblinking, lines formed between her brows.

I almost brought the jar in to show her. Why would I do that? Maybe because if it were me, I'd want to see a chunk of what was spreading through my body. But normal people wouldn't.

"How bad?" Her voice wavers.

"Wilson will tell you."

"I'd rather hear it from you."

It must be the part of her that's my girlfriend making her say that. Definitely not the Cuddy who's my boss.

"No, you wouldn't."

Her features tighten. She's unrelenting.

"Stage four renal cell carcinoma. It's already metastasised to your lungs."

A heavy breath pushes out of her as her eyes glisten. She clenches my hand the same way her fear clenches me, wrapping itself around me.

I glance to the door. The case is over. No patient to pull me away. No beeper to go off, no phone to ring, no team member to burst in with news.

That doesn't stop me from wishing.

"I should've..." I tap my cane against the floor with the hand she isn't clutching. "I should've supported you. I shouldn't have dismissed your concerns."

"What's important..." A tear rolls down. "...is that you're here for me now."

Am I? Every neuron firing in my brain screams for me to get out of here as fast as possible, to hide in my office, or even the clinic–maybe it would be good to find some idiot to ridicule. Not because I don't love her, but because I do.

12 March

It's been four days. Cuddy's checked herself out of the hospital, but not to go home, to go back to work. She's pretending it'll all go away. I want to criticize her, but that would be hypocrisy. And I hate hypocrisy more.

I push open the door to my empty office and limp to my chair. Walking's getting harder. The pain gnaws from my thigh, shooting up to my hip and all the way down to my ankle. I've barely slept. Maybe two hours last night, between the racing thoughts and never-ending stabbing in my leg.

I drop the case folder to my desk, try to force myself to scan over it again, but I can't. My hand goes to my jacket pocket and gropes the all-too-familiar cylindrical shape tucked within. I shouldn't. I know that.

Just one more.

The door swings open as the pill slides down my throat and the bottle back into my pocket.

Chase and Cameron come in, staring in that annoying, patronizing way people tend to do when they think you're falling apart. It's not the Vicodin. They didn't see.

"That a case?" Chase asks.

"Well, it's definitely not naked pictures of your grandmother."

Foreman and Masters are next. At least they're not trying to swaddle me in a blanket with their eyes like Cameron is.

"I'm fine."

"Okay," Chase says.

Cameron opens her mouth.

I cut her off. "I assume everyone knows. Yes, Cuddy has cancer. Your concerned looks aren't necessary or helpful."

"You can't be fine." Cameron steps up beside me.

"The main tumour's been removed. Wilson's working on the rest. We're not oncologists. Let's focus on the case."

"The woman you love has just been diagnosed with metastatic cancer." Cameron touches my arm.

I tighten the grip on my cane and shift away from her.

"You can't possibly be thinking about working right now."

"Yeah, why don't you go and be with her?" Chase grabs the case folder from my desk. "We can handle this."

"Firstly, I was with her. And secondly, are you sure about that?"

"Yeah, I'm pretty sure we can, actually."

"Look, you two might as well drop it," Foreman says, going for the door to the adjacent room. "It's no use arguing with him. He says he's okay, nothing we can do will change his mind. Even if it's a load of crap."

"Nice to know someone here isn't distracted by what we can't do anything about."

Chase opens the folder and reads for a moment. "Patient has a ruptured diaphragm, cracked sternum, broken nose, and partial hearing loss."

"I'm going to make a wild guess here," I say, "and assume it might have something to do with a bull jumping on him.

Wilson looks up from a stack of papers as I walk in. "You're working a case?"

"Bullfighter. Basically a walking pile of metal plates, rods, and surgical pins. Can't do MRIs, X-rays are useless."

"Sounds interesting."

"Not nearly as much as you might assume. I mean, whatever mental disorder causes a guy to enjoy being tossed around and stomped on by a two-thousand-pound animal is pretty interesting, but not my field."

"You don't really want to be working." He shuffles the papers, then stands them up and taps the bottom against the desk to tidy the stack. "Take some time off."

"What for?" I lean against the wall. My cane isn't enough. "I'm not the one who's sick."

He raises a brow at me. "House... I know this is affecting you. You don't need to pretend it's not."

I glance at his movie posters, fighting off the urge to clutch my hollow thigh through my jeans. Can't let him see how much pain I'm in, or he'll start asking crap I don't want to talk about. Like the Vicodin. And the fact it's not helping.

Better off letting him have this instead. My eyes turn to the floor now. "How is she?"

"You're asking me?" he scoffs. "Aren't you talking at all?"

"That's not what I mean. The treatment."

"No, I think it is what you mean. You don't know how to handle this."

I don't look at him, letting my fingers slide across my cane handle before digging into the wood, a substitute for my leg. "She's acting like nothing's wrong now."

"Huh."

It's so annoying when he does that. Between facing the balcony, I steal a glance of his brow raised at me. Then my eyes flick to the couch. Sitting would be so much easier right now. But I can't.

"You mean she's doing what you always do," Wilson says. "Avoiding pain at all costs."

"As opposed to everyone else in the world, who goes looking for pain like it's buried treasure?" I shift my weight and glare at him.

"Your leg is worse again, isn't it?"

Great. He's noticed. I force myself to straighten up. My thigh feels like a butcher's knife has been plunged into it. I wince. It's rending now, going up and down. My fingers squeeze around my cane so tightly it hurts, but not enough.

"You're not..." He takes a step out from behind his desk, then stops. "You're not thinking of using...?"

Sounds like he's almost afraid to ask.

My eyes meet his. "No."

"If you need to talk, if there's anything I can do to—"

"No." I cut him off. "I'm dealing with it."

His brow raises with incredulity again, but he doesn't say anything. He goes back behind his desk and pulls out a scan. He brings it close. Lungs. Cuddy's. The white blots are a stark splatter.

"I've ordered a histology of the tumour we removed from her kidney to see exactly what we're dealing with," he says. "Most likely it's clear-cell, which can be both good and bad. Hopefully it's a low grade. I've started her on pazopanib. Some of the latest clinical trials have been promising."

"Promising?" I raise my cane a few inches and let it drop again. The resulting thud isn't nearly as satisfying as it should be. "I've seen some of those on your desk. Progression-free survival in the range of months. Maybe an overall survival of one or two years. Three if she's extremely lucky. Is that what you call promising?"

"Sadly, in this field, that's often the best we can hope for." The scan crackles as it waves in his grasp. "I won't lie to you. I wish we'd caught this sooner. We don't have a lot of options at this point. But I'm going to do everything I can."

"We're better off cutting them out."

"And leave her with more holes than lung tissue? It's too extensive."

A lump lodges in my throat. It won't go down even with a hard swallow. I want to argue, to throw out ideas. But it would only serve to briefly redirect my consciousness from what's bubbling to the surface.

He's right. Unless we remove over half of both lungs, more surgery is out.

I'm in my office, at my desk, cane pressed against my forehead when the team return to tell me there's nothing wrong with the patient's inner ear. It's got to be his brain, but there's no way to see his brain, and he's got blood in his sputum. The next theory is a salivary gland tumour or a GI bleed. I send them to scope his GI tract and get a parotid biopsy.

Their footsteps become distant in the hall. The tearing at my thigh deepens. My hand finds its way into my jacket pocket, pulls out the bottle. The lid comes off with a satisfying pop. A pill rolls into my palm. I raise it, stare at it.

Just one more. No big deal.

It slides down my throat, I stand up, and for a moment I acknowledge it, what's happening. What I'm allowing to happen. I'm not an idiot. Or maybe I am.

Now I push it away, like the chair back under my desk.

I limp into Cuddy's office. She's bent halfway over her desk, shoving something into a drawer. With one of her usual form-fitting skirts and low-cut sweaters, the view's nice, but that's not why I've stopped a few feet from the door. She freezes in place and our eyes lock.

Everything is like it always is. This could be one of the last times. My leg wrenches without moving. Maybe it's not only my leg.

No. That's something stupid Wilson would suggest. And he'd be wrong.

"Wilson said you're working a case." Cuddy straightens up and smooths her skirt.

"Also that I should be holding your hand, instead. But you're going back to work too, apparently."

I move towards her, dragging my bad leg. She meets me halfway.

"I want you with me... but I'm not going to deceive myself. I know how hard this is for you." She grabs my hand. "If you need to solve a puzzle... if it'll help you cope..." She brushes my skin with her fingers, stays for a moment, then lets go and heads for the door.

"Giving up just like that?" I follow.

"Of course not." Her hand pauses at the doorknob. "And that's not what I mean. I'm just being realistic."

"Interesting. When you had no actual proof you were sick, you needed me, but now... now that you know, you're trying to tell me you're okay without me?"

She looks at me for a few seconds before opening the door. "No. It's just I know you. I know how your brain works. I don't expect you to be clinging to me every minute of every day."

"And I've got things to do too," she adds.

Things to do. Pointless things that won't matter. It's a defence mechanism. The question is, is it compensation for being unable to deal with her diagnosis, or compensation for being with someone like me?

We start out of the office.

"You'd prefer it, though. If I hung around." My leg catches. Instinct takes over and both hands clutch at the pain through my jeans as my cane clatters to the floor. I lurch forwards, about to fall to my knees.

Cuddy lands against me. I thought she was further ahead now, but her arms are steadying me. "Are you all right?"

A few nurses stare. She picks up my cane and passes it to me.

"How long has your leg been like this?"

I can't resist. "I don't know. Probably ever since it was butchered and half the muscle was carved out."

"No," she says, eyes narrowing. "You know what I mean."

"The past few days."

She stares for a moment. "Why don't we go home?"

"Really?" Sarcasm flows before I can stop it. "But what about all those important things you've got to do?"

I shouldn't be talking like this. Not now. But I have to.

She sighs. "Come on. Let's soak your leg. I'll give you a massage."

The warm water envelopes my body and dulls the sensation of thigh tissue being shredded and wrenched about under my skin. Every time Cuddy's fingers sink into the muscle and places where muscle should be, pain sears through. I flinch and tighten, then it all eases a bit.

It's ridiculous if I allow myself to think about it. She's tending to me like I'm the one who's dying. Her lungs are tumour-ridden and to look at her now, sitting in the bath in front of me, kneading my leg, you wouldn't even know she's sick.

My ringtone interrupts the rhythmic lapping of the bathwater with her movements. She smiles slightly. Surprised she can do that.

It's the team calling to tell me the patient's sclerae have turned yellow and X-rays show a mass on his liver that's being obscured by the conductive metal rod in his ribs. They argue about a potential tape worm or a detached cyst, then mention the possibility of an infection. The next step would be a lumbar puncture, which is a risk because recent skull fractures mean there could be increased ICP and his brain could herniate.

"Ventricular puncture would work," I say between grunts.

"Where are you?" Cameron asks.

Chase focuses on the patient. "You think sticking a needle directly into his brain would be less dangerous than sticking it in his spine?"

"Maybe. I'm trying to get you to hang up. We're naked over here."

"Naked?" Masters sounds uncomfortable.

Cuddy reaches and presses the button for speaker phone. "He's getting a leg massage. Nothing else."

"Is that all?" I give her an exaggerated frown.

"Okay... we'll call back after the procedure."

I hang up and put the phone back on the table beside the bath. "So... you're perfectly fine with that course of action? No reservations about drilling the guy's skull for probably no reason?"

"I trust you know what you're doing." She digs her fingers into my thigh again. I tense up. "So you'd better hope it's not for no reason."

The ambience returns to quiet splashing. And I'm left with thoughts. Thoughts of the situation. How long is she going to pretend she's fine? How long will I pretend the same? How long before it all crumbles?

"When are you going to tell Julia and your mom?" I ask after awhile.

"Soon." Her eyes cloud and glisten.

Thud. Thud. Something bangs on the door. "Mom! Mommy!" Rachel calls from the other side in a drawn out voice.

"Oh, she must have woken up from her nap." Cuddy lifts from the water and wraps a towel around herself. "Just a moment, sweetie."

I trade ridiculous faces and stuck out tongues with Rachel over bowls of spaghetti, Cuddy smiling weakly at us between more glum looks, when the team call again.

"Stinky feet can point to diabetes, athlete's foot, or gangrene," I say to them.

Cuddy dabs some tomato sauce from her lips and frowns.

"Ewww!" Rachel giggles.

"Pick one."

"Uh, none," Foreman says. "None of those cause bloody sputum or disappearing masses."

"Do you have stinky feet?" Rachel twirls some noodles around her fork.

"No." I grab my cane from where it's been hooked on the back of my chair and extend it under the table towards her. "Do you?"

"Fungal infection can cause ulceration between the toes," Cameron offers, "and bleeding could be from recurring abscesses that appear to be recurring masses."

"No!" Rachel squirms as I brush her feet.

"Are you sure?"

"Yes!" She laughs harder.

Cuddy's expression lightens, watching. Normally, she'd be complaining about such commotion over a meal. She wants to teach Rachel proper manners.

"Symptoms in the head or feet mean the infection would have to be in the heart or the brain," I tell the team between tickling. "I say we start by looking in the heart, because looking at his brain with a metal plate is problematic."

"So's MRI'ing his heart," comes Master's voice. "He's got a seven centimetre conductive metal rod holding his rib together. It'll rip him in two."

"No, it'll just feel like it's ripping him in two, which is much better." I pull my cane back and let Rachel recover.

"Ripping who in two?" She straightens up.

"The patient," I say, holding the phone away.

"Patient? Why's he patient?" She sticks her fork into a meatball and wiggles it back and forth. "Isn't it good being patient?"

"Honey, don't play with your food," Cuddy scolds.

"Patients are what we call sick people who have to stay in the hospital and take medicine so they can get all better."

"Ohhh... but I thought patience was when you wait really good."

"It's that too," I say. "Two different words."

"Who's he talking to?" Masters asks softly, probably thinking I can't hear her.

"Probably his, erm..." Chase pauses.

"Rachel, Cuddy's daughter," Cameron says.

"My, aren't we nosy?" I blurt for Masters' benefit.

"S-sorry."

"We could minimize the damage by injecting ice water into his abdominal cavity," Chase says.

"Do that, then." I hang up and tuck my cell phone into my pocket.

"You've got sauce all over, honey." Cuddy takes a napkin and wipes Rachel's mouth and cheek, then glances at me. "I'm almost afraid to ask."

13 March

Coughing jolts me from sleep. The sun glares through the crack in the curtains and makes the clock digits hard to read. It's just past nine. Must've finally crashed. I drag myself to a sitting position against the headboard. Cuddy is knelt over the toilet, visible through the open master bathroom door. Oh. Not coughing. Side effect of the pazopanib.

"Didn't Wilson give you Zofran?"

She goes to the sink, runs water and splashes her face before answering. "Yeah. Didn't help this time."

My phone buzzes by the alarm clock. I kick off the blanket and grab it. It's the team.

"The images were normal," Masters reports.

Cuddy comes out of the bathroom, dark circles drooping under her eyes. The colour of her whole face is a shade off.

"If the infection's not in his heart, gotta be in his brain," I say, watching her sit down beside me. "Do a CT scan." She's normally at work by now.

"We can't," Foreman says. "He has a titanium plate and a bunch of screws. Or did you forget?"

"No. Get rid of them."

Cuddy opens the drawer of the bedside table, rummages, pushes a sublingual tablet from its pack and pops it in her mouth. She leans back, pressing her eyelids.

"His skull has multiple hairline fractures," he argues. "Removing the metal plate would be like removing half an eggshell without cracking the rest of it."

"And not removing the plate will be like leaving the egg out to rot."

Cuddy clamps her lips, hand half raising to her mouth, expression asking if I had to be so vivid.

I hold the phone to my chest. "Sorry."

"It's not logical," Masters adds, speaker back at my ear.

"House is right," Chase says. "We have to do something."

"Thanks for your continued support, Dr Brown-Nose."

He doesn't remark, but I can imagine his eye-rolling.

"We can't cut off the top of his head based on a few symptoms that disappear whenever we try to test for them."

"And you're sure you're not just saying that 'cause you've got a crush on the guy?"

"No! I mean—I don't have a crush on him."

"Robert," Cameron scolds. "It's not nice to tease her."

"Oh, is this junior high? I didn't realise time could move in reverse. Maybe that's why vinyl's coming back."

There's a brief biting of tongues before the jab prompts a more relevant contribution from Cameron. "What if the one symptom that hasn't disappeared was never actually there?"

Interesting. "Any delays when he answers questions?" I ask. "Maybe he doesn't have partial hearing loss. He's missing moments."

"Um... he reported having something like a complex partial seizure during a bull ride," Masters chimes in again. "Said it hasn't happened since, but what if he's wrong? What if the infection in his brain is causing it to happen all the time?"

"The EEG didn't show any sign of seizure activity," Foreman says.

I hold the phone away again. "Feeling any better?" I ask Cuddy.

"A little."

"Just because it's like a seizure," I say into the phone, "doesn't mean it is a seizure."

"Surgery is still a possibility." I burst into the hospital room with no regard for the little bald kid of indeterminate gender lying in the bed, or the parents nearby, only Wilson's consoling profile clear in my focus. Sadly, that distinction is lost within seconds.

"W—wait." The stammering father interjects. He blinks rapidly. "I thought the tumour was inoperable."

Wilson flashes me his 'what's wrong with you?' look. "It... um, it is."

The mother gasps, hand over her mouth. Her husband rubs her shoulder.

"This isn't about you," I say.

Their faces warp with a mix of confusion and disgust.

"I'm sorry. You'll have to excuse me for a minute." Wilson sets his folder on the nearby cart. "I apologise for my colleague's total lack of sensitivity."

He ducks from the room with me.

"Thanks for that. Now I have to finish explaining to devastated parents that their child is, in fact, terminal and probably won't be around in five months."

"Oh, come on. They already knew that. How many sad little dying kids actually make it to their twentieth birthday?"

"That's not the point." He sighs, glancing at the nurse rolling a cart past us. "I assume you're talking about Cuddy."

"We just need to shrink the tumours."

"Oh." His eyes refocus on me. "Is that all?"

Yeah, that sounds stupid and over-simplified. His arched brow doesn't tell me anything I didn't already know.

"We should start her on high-dose interleukin-2."

"Because, apparently, I wrote her a prescription for candy."

"It's still got a better overall response rate than the TKIs."

He tilts his head, thinking before answering. "Not necessarily. Pazopanib, sorafenib, and sunitib, all have a good chance of generating a response. And this is her choice. I ran her through the options. She wanted an oral route."

My mouth opens, though the words aren't even clear yet. It doesn't matter. Before I can utter a syllable, the team loom into view.

They report that the CT is clean, there's no infection in the patient's brain. That leaves us with no choice but to blow up his heart. Needless to say, the idea doesn't go over well with any of them. Wilson eyes me with disbelief before returning to his own patient. He wants nothing to do with it.

The team bicker with me to little avail before their inevitable surrender to the only option. They've been looking the wrong way. It's an imperfection we're after. We need to pressure his aorta to the point of ripping, so we can find it and repair it.

The surgical team below prepare for the unorthodox procedure. Cuddy's reflection surfaces in the glass pane. Oh, here we go. I brace myself for the barrage of all the hundreds of reasons why this is unethical and she won't allow it.

"Let me guess, I should call off the surgery?" I raise my cane, ready it towards the glass, even though I've got no intention of following through with striking.

She stares solemnly, then answers. "No."

What the hell does that mean?

"You're actually saying 'yes' to rupturing a patient's aorta?"

"You're doing what you think is right." She watches the scalpel sink into the patient's chest. "I'm not going to argue."

Something swims through my veins besides blood. It's not relief. My gaze, too, fixes on the surgical team below. Coordinated movements flow with almost hypnotic precision, offering an attractive diversion from racing thoughts.

I allow myself the respite of avoidance until red gushes past their gloves and motions turn frantic. Their problem. Not mine. My problem is on this side of the glass. My facial muscles tighten, casting harshness towards her. "Where's the logic in that?" I ask, finally.

She looks confused. Maybe I waited too long for that to be in context. Or she's only feigning ignorance so she doesn't have to answer.

"You allow a ridiculously dangerous procedure, no questions asked, because I feel like it's the right thing to do, but you're not prepared to accept advice regarding your case, are you?"

She hesitates. "Why? What do you think I should do?" she asks in a tone not as open to input as the question suggests.

"Drop the pazopanib. Start on high-dose interleukin-2."

"So, trade a newer treatment for an older one."

"Newer's not always better. It's got a longer track record."

"Of failure."

"With a chance of complete cure," I say. "What else can boast that at this stage?"

"Wilson's already gone over it with me. It's unlikely."

"Either way, there's a significant chance the lung metastases will shrink enough to surgically remove."

"Chance." She sighs, glancing to the surgeons hurrying to clamp the tear. "And they might do that with the pazopanib, anyway."

A blood-drenched, gloved thumb sticks up. "House! We've got it!" Chase calls.

I give him a nod. What's normally a surge of dopamine is hollow, nothing more than an empty answer to push away a question.

14 March

I roll the over-sized tennis ball across my desk. Puzzle solved, there was no point in coming in today, unless I plan to spend it in the clinic examining oozing genitals and swollen haemorrhoids. Should have stayed at home playing video games. And the sad part is Cuddy wouldn't have argued. She's too busy struggling to keep her usual pace. The strain is clear, like a rickety, dry-rotted plank trying to support an entire roof.

I recline in my chair, thumbing over the pill bottle in my pocket. It rattles as it shifts. Still almost full.

Wilson bursts in.

I flinch, pull out my hand, sit up straight.

"I've got the results," he says, clasping a folder at his side.

"And?"

"It's clear-cell, of course, but..." He lets out a deep breath, closes his eyes for a moment. "Grade 3 with greater than fifty-percent sarcomatoid features."

In other words, more bad news.

He sets the folder on my desk and I pore over the purplish photos of the cell culture, a mess of splotchy tangles with dense spatters of near black. The texture evokes the mould infested foam lining under the old carpet of my first apartment.

"I've already told Cuddy," he says.

And suddenly, those oozing genitals and swollen haemorrhoids seem almost appealing. Ugh, wrong word. No, it doesn't matter. I'd honestly rather be wrist deep in some random guy's ass right about now.