Tuesday, December 05, 2006

Pancreatic cancer

mood: need for coffee

music: would love to hear some Swing

I am in need for a strong coffee and will probably go and fetch me some, before making my ward round.

Greg came around with the testings and we checked the file together with Danby.

Afro-american man in his fifties, obesity, abdominal pain, loss of appetite and his gallblader is distended. His bilirubin, γ-glutamyl transpeptidase and alkaline phosphatase levels are raised. Together with a carbohydrate antigen of 19.9 this is a marker for cancer.

We have to check now if the pancreatic tumors are adenocarcinomas or, which is very unlikely, pancreatic neuroendocrine tumors. "So we will first make a somatostatin receptor scintigraphy and if this doesn't work a Gallium-68 receptor PET-CT", Greg said and looked at me. I nodded "Yes this should be done, although I doubt that it is such a rare kind of cancer." Greg raised an eyebrow and grinned "Everything can be possible".

He stood up "Let's wait for the test results", he handed Danby the file who stood up "I'll initiate the testings", he said and proceeded to the patient.

I leaned back in my chair and strechted a bit. Greg watched me and smiled "Tired?", "Mhm" I nodded. "We haven't been in bed that late" he mentioned and approached me. I crossed my arms behind the head "Right but it was late when we finally slept" I said with a yawn. Greg rested his arms on the armrests and slightly leaned over me "What about a nice little ...", unfortunately his offer was interrupted by a knock at the door. I rolled back with my chair and Greg straightened up, the door opened and Cuddy peeked in.

"Ah here you are", she said and entered the room. "House, there is clinic duty waiting for you" she snapped and gave him a stern look. "You don't have to remind me of that!" he gnarled. "We had to discuss a case here" I said with a placable voice, "You wanted to talk to me?" I asked her.

She looked from one to another "Well, actually I wanted to ask you both where the festivity will take place on Saturday?"
Greg leaned on his cane and said dryly "This depends...", I looked at him but decided to say nothing at all as I could see there was something in his mind. "Depends?" she snapped back "On what?!" He still looked stern and answered "If we have to work until the last hours in the clinic, it might probably not take place due to overfatigue and no time for planning!" Cuddy rolled her eyes to the ceiling and then looked at me "Wilson! Tell me where will it take place?", I just shrugged "We had no time to make any reservations so far, you know" I said with an apologizing smile.

Cuddy sighed "Your family and friends are coming and you have not made any reservations so far? C'mon I don't believe you!", "Of course we had not time. There is no time to make any arrangements if we have to stay here all the time" Greg grunted back.

She thumped her block with the pencil and looked at us enquiringly. We both looked innocently back, she finally raised her hands and said "Okay, okay - no clinic hours for you on Thursday and Friday" she sighed and turned around. "And I have to know by tomorrow where it will take place as I have to make plans as well. By the way, is there some dress code?!" Greg nodded "Just don't wear such ..." he pointed at her blouse "delicate clothes. You don't want to cause the rabbi an eye complaint, do you?" She grunted and went outside.

I snickered "You are unbelievable, Greg". Greg turned to me "Yes but we have two days off clinic duty. 'Course we could have told her that we will celebrate at Arnello's but so we have some time for us." I shook my head and pointed at him with my pen "Yes, but we really have to make some planning for Saturday", he sighed and turned to the door.

"You know we have to" I exclaimed but he already was out of the room. The smile still remained on my face when I turned to the computer to check some databases.

Perhaps I should call my Mom and ask if they already made some arrangements ...


Anonymous said...

"Just don't wear such ..." he pointed at her blouse "delicate clothes. You don't want to cause the rabbi an eye complaint, do you?"

That was cool Greg need to try that on Maddie! Oh and what are you two up too? Whats with needing to find a place?

Dr. James Wilson said...

Ehm we need a place for our Jewish ceremony.

You really are not up to date, huh?

We are married ...

Dr. Gregory House said...

Obviously not...
I hope Cuddy takes this to heart.

Anonymous said...

I knew you two are married *smiles* Buy why the Jewish thing? (Sorry not up to date on my religon).

Dr. James Wilson said...

Because we got married without our families - and well my parents are looking forward to it ...and I think Greg's too

Anonymous said...

Awwww *pinches Greg's cheeks* Thats cute Greg. And good luck on finding a place.

Dr. Gregory House said...

We already have a place, thanks.
*rubbing my cheek*
It's Arnello's.