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= 12 - 4(x+9)/x^2 - 81
= 4(3-x-9)/x^2 - 81
= 4(-x-6)/x^2 - 81
= 12/(x-9)(x+9) - 4/(x-9)
= 12/(x-9)(x+9) - 4(x+9)/(x-9)(x+9)
=12-4(x+9) / (x-9)(x+9)
=12-4x+36 / (x-9)(x+9)
=-4x+48 / (x-9)(x+9)
=-x+12 / (x-9)(x+9)
=-x+12 / (x^2-81)