Tucker is the patient in the episode Wilson who is an old friend and former patient of Wilson. He and Wilson go hunting every year to celebrate that he is still cancer free.
Medical History[]
Tucker was diagnosed with leukemia by Dr. Wilson on May 30, 2004. At that time, he had roughly six months to live if his treatment didn't go well. However, Wilson treated him with chemotherapy and he survived another six months. By 2009, he had made it to five years without any further symptoms and he remains close friends with Wilson.
Case History[]
While out hunting, Tucker suddenly lost control of his legs and became unable to move his arm. Dr. Wilson suspected a stroke but managed to get him back to the car and back to Princeton-Plainsboro Teaching Hospital.
Dr. Wilson admitted Tucker and did a head CT scan which luckily ruled out a stroke. His blood count and blood cell morphology were also normal, which appeared to rule out a return of leukemia. However, he noted that Tucker's girlfriend had a cold sore. Dr. Wilson realized if Tucker had been exposed to herpes, it might have spread to his spine and caused paralysis - transverse myelitis. He got Tucker into a hospital room and started him on aciclovir.
However, when Dr. Wilson reported the diagnosis to his friend Dr. House, Dr. House thought it was more likely to be cancer due to Tucker's low white blood cell count and left arm paralysis. Dr. Wilson noted there were no AML cells, but Dr. House thought that Dr. Wilson was looking to hard for a zebra without ruling out the obvious diagnosis and he wasn't being objective because Tucker was his friend and a cancer survivor.
However, Tucker was complaining that his foot was tingling. Dr. Wilson realized the acyclovere wasn't working and gave him ribovirin as well. He told him not to worry about a recurrence of his cancer. Tucker asked him to call his daughter Emily for him as Emily had not been speaking to him since he broke up with his wife.
Dr. Cuddy asked Dr. Wilson how Tucker was doing, but also asked if Dr. House had any insights. She was worried that Dr. Wilson was treating a friend.
Dr. Wilson assured Tucker and his girlfriend that he should be able to move his arm again soon. However, Tucker had developed a cough as well. Tucker's daughter Emily and his ex-wife Melissa arrived. Tucker's cough got worse and Dr. Wilson realized that whatever he had, it was affecting more than his nerves. Tucker's vital signs started to crash and Dr. Wilson called for a crash cart and gave Tucker oxygen.
Dr. Wilson approached Dr. House for a consult, but could not find him so he asked his team for help. Dr. Chase realized that Dr. House was in favor of cancer. Dr. Taub thought it might be a subdural hematoma, but the CT scan was clean. He told the team Tucker got worse on antiviral medication. Dr. Foreman thought it might be a bacterial infection, but it was moving too slowly for a bacterial infection. Dr. Hadley thought it might be a fungus, but although it would explain the fungus, it would not explain the paralysis. However, Dr. Wilson realized that aspergillis fungus balls might have started in his lungs and spread to his spine, which would explain the paralysis.
Dr. Wilson explained the procedure - they would inject miniature pellets of anti-fungal medication into site where he appeared to have fungal infections. It would require surgery. Dr. Wilson didn't think there was time to test or try intravenous medication. However, Tucker was still strong enough to endure anesthetic. He finally consented to surgery and asked Dr. Chase to prep Tucker for surgery. However, Dr. House found Dr. Wilson and told him he disagreed with the fungus diagnosis.
Dr. House came to observe the surgery. Dr. Chase reported that Tucker had global lung damaged, which ruled out a fungus. Dr. House noted that Tucker's immune system was compromised, which meant either HIV, acquired SCID or cancer. Dr. House brought the test results to Dr. Wilson which indicated it was cancer.
Dr. Wilson broke the news to Tucker - he had acute lymphoblastic leukemia. However, it was not a recurrence of his original leukemia, but a different one, most likely caused by the chemotherapy treatments for his first leukemia. However, it was limited to his brain which meant since it was too big to get through the blood-brain barrier that it was unlikely it had spread anywhere else. He was 90% likely to be completely cured, but otherwise he would most likely only live another six months, although his quality of life would be good during that time. He would not need a bone marrow transplant and could be treated with chemotherapy alone, although he would need to have a shunt surgically implanted so they could deliver it directly to his brain. He appointed his ex-wife as his medical proxy.
However, Tucker did not respond well to treatment and his paralysis persisted. Dr. Wilson realized that the leukemia had become resistant to chemotherapy due to his first treatments five years earlier. Dr. Wilson planned to double the dose of chemotherapy to see if the leukemia would respond. When Dr. House found out, he reminded Dr. Wilson that chemotherapy was toxic and that side effects were more likely with a higher dose. He also pointed out that when a doctor is being objective, they can deal with a treatment going badly, but when they are not objective they have trouble handling the consequences.
Dr. Wilson presented the option to Tucker, who agreed to the double dose. The next day, the paralysis had abated, but Dr. Wilson looked at him and realized he was jaundiced. The cancer was gone, but half of his hepatocytes were dead - Tucker had permanent and irreversible liver damage. He would not survive for more than a day without a transplant.
Dr. Wilson gave the news to Tucker. He was at the top of the transplant list, and his ex-wife, daughter and girlfriend were not compatible donors. However, Dr. House came in with news - a patient in the emergency room had died and he was a compatible match. However, he had no donor card and his next of kin refused consent. Dr. House and Dr. Wilson went to speak to the next of kin, but by the time she was willing to agree, the liver was no longer viable.
Tucker was inconsolable, but remembered that Dr. Wilson had the same blood type (O-) as he did. He asked Dr. Wilson for a live donation of a lobe of his liver. Dr. Wilson agreed to it, although both Dr. House and Dr. Cuddy tried to talk him out of it.
The transplant surgery went well for both Dr. Wilson and Tucker, and Tucker was soon recovering. Dr. House helped Dr. Wilson through his recovery. Tucker decided to stay with his girlfriend rather than his ex-wife.