House, MD Nominations & Awards

"House": The Show
Nomination: Producers Guild Awards nominees Nominations announced January 3, 2007 Episodic television, drama: "Grey's Anatomy," "House," "Lost," "The Sopranos," "24." 18th Annual Producers Guild Awards will be announced January 20, 2007
Nomination: Emmy (2006)
Nomination: TV Critics
The American Film Institute's Awards of 2005 - "House" is one of AFI Top 10 TV Programs of the Year ("..HOUSE's focus is on the pharmacological--and the intellectual demands of being a doctor. The trial-and-error of new medicine skillfully expands the show beyond the format of a classic procedural, and at the show's heart, a brilliant but flawed physician..)
Nomination: NAACP Image Awards -->
The Writing:
Win: Emmy 2005 - David Shore won the Emmy for Outstanding Writing for a Drama Series for the Season One episode "Three Stories"
Win (2006): Writers Guild of America - "For Episodic Drama: "House, M.D." - Lawrence Kaplow - For episode "Autopsy". "
"Three Stories" won the Humanitas Prize, for screenwriting that helps "entertain, engage and enrich the viewing public." from a "deekay" posting at the Television Without Pity's House Forum a quote from an AP story on it: "Judges cited its 'poignant probe into the pain and confusion that comes when someone we love disappoints us.'"
The Acting: Hugh Laurie

Win: Screen Actors Guild (SAG): Outstanding Performance by a Male Actor in a Drama Series January 28, 2007 See a transcript of his acceptance speech - note: it's more than half way down the page.
Win: Best Actor Golden Globe Award January 15, 2007 In his speech Laurie said, "I am speechless. I'm literally without a speech. It seems odd to me that in the weeks leading up to this event, when people are falling over themselves to send you free shoes and free cufflinks and free colonic irrigations for two, nobody offers you a free acceptance speech. It just seems to me to be a gap in the market. I would love to be able to pull out a speech by Dolce & Gabbana."

Win: TV Critics 2006 and 2005 July 23: "At the 22nd annual Television Critics Association awards" - the second win in a row. See this blog on the 2006 Individual achievement in drama, to Hugh Laurie of 'House.'" for some excerpts from Mr. Laurie's acceptance speech including: "I feel very much in the position of the man who has got a very, very fast car. ... I am, every day that I go to work, deeply sensible of the honor I have to sit at the wheel and drive this wonderful character called House." Images of Hugh Laurie's acceptance speech: Image A, Image B and Image C and at the hughlaurie.net News page
Win: Golden Globe January 2006
Julie of housefans.net has put up a transcript of Laurie's very funny speech
And see a picture of him on stage and comments about the speech.
Win: Satellite Award Outstanding Actress in a Supporting Role in a Series, Mini-Series or Motion Picture Made for Television for: "House M.D." (2004)
Nomination: Emmy 2005 Outstanding Lead Actor in a Drama Series
Nomination: Screen Actor's Guild 'Best Actor in a Drama Series' award (SAG Awards to be announced on TNT Jan 29, 2006)
Win: The Television Critics Association awards - Best Actor on a TV Drama (July 2005)
Hugh Laurie got a nod for one of the sexiest men on TV in "Who" magazine just recently. "Who" magazine is the Australian equivalent and sister magazine of "US" Magazine in the USA. (info from post by "Wallaby" in Television Without Pity's House Forum
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The Acting: Others
Omar Epps — Nomination: NAACP Image Awards
The Directing:
Nomination (winners will be announced Jan. 28, 2006): Director's Guild of America "Paris Barclay for the 'Three Stories' episode of 'House'"
Other Awards and Nomination
Nomination - Emmy 2005 Outstanding Casting for a Drama Series: Amy Lippens, C.S.A.
Nomination - Emmy 2005 Outstanding Main Title Design: for "House" title design
Matt Mulder
Jake Sargeant
Dan Brown
Dave Molloy
Nomination - Emmy 2005 Outstanding Music Composition for a Series: Christopher Hoag

House, MD Season 4 Episode 412: Don't Ever Change

At her Hasidic Orthodox wedding to Yonatan Arnoff, a woman named Roz Viner becomes ill. As she is lifted in a chair for a traditional Jewish wedding dance called the hora, she falls off and loses control of her bladder. She breaks her leg in the fall.
House approaches Wilson and presses him about dating Amber. Wilson tells him that they have been together for four months.
The Fellows wait for House in his office. Thirteen hands him Roz's file. In the midst of discussing the patient, the men on the team want to talk about Amber. Thirteen suggests that Roz has Endometriosis of the bladder. Kutner brings up carbolic acid poisoning.
Taub and Foreman go to Roz's apartment and find hard rock CDs that she served as a producer on. When they return to the hospital and ask her about them, Roz explains that she only converted to a Hasidic a few months ago. Although previously into drugs and sex, she has now reformed her ways.
Amber enters her own apartment to find House there. He wants to know if she using Wilson just to get to House.
Roz's condition has not changed and she tests negative for endometriosis or drugs. House thinks that her conversion to Hasidism six months prior is a sign of porphyria -- a rare genetic disorder that causes an over-production of certain proteins that contribute to mental problems.
Kutner tells Roz and her husband about House's theory. Yonatan asks Cuddy for a new doctor. Cuddy sees that the team has brought up the possibility of cryoglobulinemia, so she instructs them to treat her for that. Suddenly, Roz lapses into a hypoxic state. The team reviews the symptoms: bloody urine, no bladder control, altered mental status and dyspnea. Foreman suggests Wegener's, while House considers Lupus.
House goes to the restaurant where Wilson and Amber are on a date. Amber asks him to join them. She gets the maitre d' to seat them ahead of the other people waiting. House sees many of his own qualities in Amber. He questions whether Wilson is really in love with him instead. House runs out.
Roz undergoes a cardio stress test while Taub and Yonatan discuss marriage. Roz falls to the ground, crying in pain about an unbroken leg. House orders Foreman to do an MRI to look for blood clots in her leg. Foreman and Thirteen conduct a brain scan. Foreman claims Thirteen is bisexual.
House thinks Roz gets a form of pleasure from pain. He tells Foreman to restart her IV to cause her discomfort so that her reaction will show up in the brain scan. House is proved right, but Roz tells Thirteen that she had been praying. This could explain the brain activity. When Roz rises from the machine, her vital signs drop and she collapses.
Roz's vitals are stressed when they should not be, and the team tries to figure out why. It may be an electrical problem in her body. Roz gets her heart tested by Taub and Kutner. Although she is supposed to be sedated, Roz hears them talking.
Roz undergoes another test inside a chamber with rising heat to test her body function. She is not sweating in the heat. She starts shaking and has a seizure. Thirteen finds that Roz's body is freezing. The team ponders why her body is physically showing the opposite of what it is supposed to be doing. She could have Addison's and be in need of cortisol.
House asks Cuddy to sleep with Wilson in order to save him from Amber. Cuddy warns Wilson about the former Fellow.
Roz begins to feel better with cortisol but then she suddenly falls into shock. Thirteen inserts a syringe into a swollen area on Roz's abdomen. She is bleeding internally. Chase examines an MRA of Roz. She is not bleeding from the source of the problem. She will have to be opened up. Roz wants to wait until later that night, to spend one Shabbat with her new husband. This gives the team less time to diagnose her. Chase suggests to House that they "move" sundown earlier so that she can have her Shabbat in her room.
Amber comes to see House. He makes her an offer. If she can solve this case then she can return to Princeton-Plainsboro -- on the condition that she leaves Wilson. Amber turns him down.
The team impatiently waits for the Shabbat ceremony to end. House has Roz stand up and he holds her right abdomen. When he lets go, her vitals go haywire. He says that she has nephroptosis -- a "floating kidney." It was shaken loose during the hora dance and has been dropping ever since. She can have it reattached.
House finally concedes to Wilson about Amber. Wilson comes after him in the hospital lobby. He can't believe that House would approve of his relationship.

House, MD Season 4 Episode 411: Frozen

At an American base in the frozen South Pole, a man named Sean tries to fix an electrical generator system during a storm. He heads back to his station when a blade from one of the windmills snaps off and hits him in the leg. He radios for help. Dr. Cate Milton rushes through the snow to get him. Back inside, Cate attends to his wounded leg when suddenly she falls and doubles over in pain.
At Princeton-Plainsboro, Cuddy finds House in a comatose patient’s room fumbling with the TV. He has been requested to treat Cate, who is an adjunct professor at the hospital but is located in the South Pole. Cuddy also informs him that cable is now available in rooms -- for a fee.
House and the team discuss the possible diagnoses of kidney stones or appendicitis. He presents a box in which the contents are the only supplies that Cate has available to her. House goes to Cameron and urges her to press her budget committee to reinstall free cable in patients’ rooms. House sends Taub, Kutner and Thirteen to annoy Cameron in the Emergency Room. They tell her that they are staying there until House gets his cable TV restored.House and Foreman talk with Cate over teleconference. She has a plastic jug filled with water and an egg hanging on a wire ring with a flaw detector to produce sound waves. Cate performs the sound wave procedure and the egg splatters. Foreman asks her to do a chem 7 test to check her kidney function. House tells her to administer cefuroxime to herself in the meantime.
Foreman informs Cate that her kidney function is declining. House notices that she has not been taking the medicine. She wants to save the limited supply that is at the base. Cate breathes heavily. Foreman and House can see that her neck veins are distended. Her lung is collapsing. They instruct her to stab herself in the chest with a syringe to inflate her lung.
Cate resorts to using an oxygen mask to breathe. Foreman covers the webcam microphone and says aside to House that she may have cancer. House tells Cate this, and asks her to x-ray her whole body, since that’s the only imaging equipment on the base. She takes the images of herself. Wilson and House examine the slides and find a lymph node enlarged in her chest. They need to do a biopsy and find a stain. House realizes that Wilson is unusually wearing a lavender shirt. It’s for someone in particular.
House speaks to Cate online from his apartment. She resists taking her clothes off for an examination because he’s alone at home. She asks to get a look at his place and he moves the webcam around to show her. Cate analyzes him. Meanwhile, as Foreman and Wilson search for a dye to use in the biopsy, they remark how Cate is perfect for House.
House guides Cate in finding the lymph node in her body. She detects a swollen one in her stomach. Wilson and House supervise her biopsy of the node. She inserts a needle into her belly. Wilson is quick to notice that House is weirdly kind to Cate, and he senses that House has feelings for her.
House asks Wilson who he is going to meet for lunch. Cameron tells House that she has resigned from the budget committee. Thirteen, Taub and Kutner remain waiting for House in the Emergency Room. He enters with a stack of fliers that have Cameron’s phone number listed below a headline for free puppies. House wants the team to get Cameron to make an error in the ER so that she can be blackmailed for cable TV.
Cate has put the biopsy into red wine. Wilson looks through her microscope at the image. He assures her that she does not have cancer. Yet she still is in pain. Her kidneys are failing.
Once again, House talks to Cate over webcam from his apartment. He thinks she may have autoimmune diseases SLE or vasculitis, and wants her to start on prednisone. She wants proof before she takes the medication.
Back in the office, Foreman suggests that Cate go outside to cool the inflammation. House has taken Wilson’s wallet. Yet Wilson comments that House only took his receipts and left the cash.
To test for autoimmunity, Cate must drop a paperclip in a test tube of her blood. If she does have it, her cells will enlarge. House talks to Cate again later that night from his home.
The next day at the hospital, Cuddy tells House and Foreman that she was forced to fire Cameron for a mistake in the ER. House thinks Cuddy is lying. Cate appears on the webcam. Her test is negative. Foreman wants her to try going outside in the cold temperature. House insists that she take the prednisone but she passes out in a coma. House pushes Wilson to reveal his new girlfriend’s name.
House gets Sean to drink Cate’s urine. A strong taste means that there is a kidney problem, but if it’s watery then the problem is in the brain. House realizes Sean in love with Cate.
House confronts Taub about whether Cameron was really fired. Taub admits that it is a lie. House lectures his Fellows to not play games with him. They need to pay for his cable.
Sean tastes Cate’s urine and finds that it is watery. She may have increased intracranial pressure or a hypothalamus malfunction. Sean will need to drill into her skull. Since he’s not a doctor, Foreman and House walk him through the procedure.
Cate regains consciousness. The team tries to come up with reasons for the symptoms. Kutner suggest fat emboli clotting her blood flow. House says this is impossible unless she has an unrepaired broken bone. He realizes that he did not see her feet during the exam because he let her keep her socks on. Her big toe is broken. Bits of bone marrow have been leaking into her blood stream. Cate is surprised because her toe does not hurt. Sean pulls the toe to fix the broken bone. He and Cate embrace as she thanks House.Wilson is waiting for his date in a restaurant when House arrives to badger him about the date’s identity. House turns to see Amber -- the “cutthroat bitch” former Fellow. She greets Wilson with a kiss. House is shocked.

House, MD Season 4 Episode 410: Its A Wonderful Lie

Eleven year old Jane climbs a rock wall at a gym. Her mother, Maggie, coaches her from below. Unable to climb anymore, Jane slips down the wall and propels downward. Maggie cannot grip the rope holding her daughter because her hands have become paralyzed. Jane plunges to the floor and lands on her arm.
Foreman, Taub, Thirteen and Kutner review the case of the hand paralysis. House enters and pulls down Kutner’s Christmas decorations. Thirteen explains that Maggie’s mother died of breast cancer when she was young. Maggie inherited the BRCA1 mutation so she underwent a preventative double mastectomy. House tells the team to MRI the woman’s chest to see if she still developed breast cancer.
After talking to Jane, House discusses with Wilson the role of lying in interpersonal relationships. House is annoyed that Maggie claims to be so forthright with her daughter. He senses that there is a lie somewhere. Wilson gives House the results of Maggie’s MRI. She does not have breast cancer.
House wants Taub and Foreman to follow up with Maggie’s recent multiple sex partners. They meet with Roger, who admits giving her the drug ecstasy. They take his stash for examination.
In the clinic, House examines a young woman for strep throat. He deduces that she must be a prostitute. Taub tells him that Kutner is starting Maggie on hemodialysis while Thirteen examines the ecstasy. During the treatment, Maggie loses her sight.
The team gathers in the office to confer about the case, but House has prepared a Secret Santa game for the group. Thirteen reports that the ecstasy is clean. Foreman suggests that Kearns-Sayre Syndrome fits the symptom of blindness. House wants Thirteen to go to the patient’s home to find her computer. Taub wonders if the patient has Multiple Sclerosis. House orders an MRI for MS and a fluorescein angiogram of the patient’s eyes.
In the doctor’s lounge, Wilson asks House about the Secret Santa for the team. House intends for it to start infighting among them.
Kutner and Thirteen return to the hospital with the laptops from Maggie’s apartment. The eye test is negative and there is nothing abnormal on the MRI. As the team looks on the patient’s computers, Foreman suggests that perhaps her brain has a conversion disorder where her mind is tricking her body.
House asks Jane to lie to her mother because it will help diagnose her. Taub pretends to administer medicine to Maggie and tells her that Jane has to stay out of the room.
The doctors realize that House gave all of them his name in the Secret Santa game. They debate whether to even get him any presents. Meanwhile, Maggie is unable to breathe as her lymph nodes swell and cut off her airway.
In House’s office, the team searches Maggie’s emails for any information that might help them. House announces that she suffers from sarcoidosis. From the emails, he sees that she has had trouble walking for a while. House opens a gift that has been sitting on his desk. It is an iPhone. Thirteen thinks House gave the gift to himself, but House is pleased that he caused the team to argue.
Maggie is given a bronchoscope test on her lungs. At the end, her eyes start to bleed. She does not have sarcoidosis and her blood platelets have dropped. The team scrambles for answers. Kutner tells House he is his secret Santa and hands him a small gift.
In the clinic, House treats the young woman with strep. He asks if she performs a donkey show. She says yes and invites him to it.
Chase and Foreman perform a bone marrow biopsy on Maggie. The drill, however, cannot penetrate her bone.
Maggie is in her room after being given a full body bone scan. The team bickers about the scan. Foreman suggests that perhaps her entire skeleton is turning to stone. Kutner mentions carbonic anhydrase type II deficiency genetic disorder. House orders blood tests. If it is positive, then she will need a bone marrow transplant. Jane is the best donor choice, but Maggie forbids her daughter from doing so.
The results show that Maggie is suffering from something worse than CA-2 deficiency. House orders the team to research the cause. Jane comes into the lab and says she wants them to test her bone marrow.
House questions whether Jane is not really Maggie’s daughter. Maggie confesses that Jane’s biological mother was a drug addict who didn’t want the baby. Jane bluntly tells Maggie that she is going to die.
House enters the Christmas party in the lobby, and grabs Wilson. House says he is impressed by Jane’s ability to tell the truth.
House comes to the lab, singing. House tells the team to give Maggie an anti-psychotic drug called risperidone. House explains why as he examines the patient. Although they discounted breast cancer in the beginning, sometimes extra breast tissue is found in areas of the body where it does not belong. Risperidone causes breast tissue to swell, making it more detectable. She could have breast cancer outside of the breasts. House finds a lump at the back of Maggie’s knee. He stabs a syringe into it as white liquid pours out. He tells Jane to open her mouth and he squirts the liquid in. Risperidone causes galactorrhea, which is milk production. House calls for chemo and removal of the tumor to treat Maggie.
As House exits the hospital, he walks past his team who is at the hospital party. His scheme to split them up failed. House enters a church service in the middle of a living Nativity scene. The woman from the clinic is playing Mary. She rides in on a donkey. House exchanges knowing glances with her.

House, MD Season 4 Episode 409: Games

Jimmy Quidd, a hard living 40-something rocker, hangs out in an alley behind a nightclub. His band waits for him to go onstage. Quidd takes his bandmate’s new guitar and smashes it. He declares that he is ready. Following the musicians inside, he coughs uncontrollably and collapses in the alley.
Cuddy interrupts House’s soap opera watching to press him to make a decision about the Fellows. She threatens to move his parking spot if he doesn’t pick his new hires.
House searches for a case in the ER and finds Quidd. He introduces Quidd to the Fellows in the lecture hall as the final case of the competition. With multiple problems, Quidd also has drugs in his system. Foreman argues that Quidd is merely a drug addict, but House is insistent that the patient suffers from so many symptoms that it has to be something else making him sick. House declares that only the person who is given the anatomical model of an eyeball can run tests. He hands it over first to Amber.
Foreman complains to House about making this hiring process a game. House asks Wilson for his opinion on Amber. Wilson just realized that he has misdiagnosed a healthy patient with terminal cancer.
As they wait for Quidd outside the men’s room, Amber and Thirteen bicker. His oxygen tank explodes when he sneaks a cigarette. He lies injured on the floor of the bathroom.
Accompanied by House, Wilson meets with the misdiagnosed patient to tell him the good news. The patient is actually upset that he will live because of how the terminal diagnosis changed his life for the better.
House tallies up each Fellow’s points. He asks Amber and Taub to do a biopsy on Quidd, who resists their attempts to insert the tube in his arm. His heart rate rises. Foreman quickly gets the tube in Quidd’s arm. Foreman reveals that the patient’s arm is covered with nicotine patches. The man’s fingers have blood clots.
House asks the Fellows what could be causing the clots. Thirteen suggests Malaria. House gives the eyeball to her. House inquires about why Amber hates drug addicts, but he really wants to know why she is so afraid of not winning. Amber says she will do anything to not lose.
Taub has a bag of prescriptions for House. He really doesn’t care about the patient. He and Thirteen realize Quidd is missing. House is in Wilson’s office playing a song by Quidd. Wilson is going to give money to the cancer patient and get a liability waiver. Taub and Thirteen tell House that the patient is missing. House talks to Thirteen to find out why she has sympathy for Quidd. She believes the drugs are masking something else.
Taub and Thirteen find Quidd playing with kids in the pediatric ward. Quidd collapses.
Cuddy tells House to contain his patient. He says that he wants to keep all the Fellows. Cuddy would keep Kutner and Taub. Kutner and Thirteen come in to tell them that the test for Malaria was negative but that they found bad blood fragments.
House goes to talk to the members of the band. He finds a dirty syringe in one of the guy’s jackets. Sharing needles is the cause for the blood clots and the bad blood fragments. They find Quidd on the floor in his room suffering from respiratory failure. They put him in the ICU. Foreman watches as the Fellows and House regroup in a laundry room.
Wilson writes a check to his patient but the man rips it up. He wants to sue the hospital for more money because when Wilson told him he was going to live, it ruined the happiness he had found.
House finds that Quidd has masses around his heart. He looks over the test results with Taub and Kutner. House wants Chase to do exploratory heart surgery on the patient. Chase resists but then Taub convinces him. Taub assists Chase on the surgery and they see swollen lymph nodes. Quidd’s blood pressure suddenly drops.
In his office, House fires and rehires Kutner and Thirteen in order to shake them up. Until they can find the source of the drugs, House tells them to treat Quidd for heavy metal poisoning. Amber treats Quidd in the ICU.
Wilson comes to House about his legal problems. Kutner tells them that one of the guys in the band told him that Quidd visits an orphanage every week.
In the lecture hall, House becomes frustrated and fires Taub and Amber to make them more competitive. House and the Fellows go to Cuddy to get approval for a brain biopsy on Quidd. House diagnoses measles in the brain. He could have contracted the disease from his lowered immune system and the time he spent around children. Cuddy agrees, but only if he can induce a seizure. House blasts Quidd’s music to irritate his brain.
In the lecture hall, House plays Quidd’s early folk music from before he went punk. House fires Amber and Thirteen. He’s keeping all the men. Amber is upset. Amber tends to Quidd in his room as he is treated for measles. Cuddy insists that House keep one woman on his team. She wants him to hire Thirteen back. House smiles. That was his plan all along.

House, MD Season 4 Episode 408: You Don't Want To Know

Kutner and Cole are in the audience of a magic show in a night club in Atlantic City. Finn, the magician on stage, is replicating Houdini's famous water chamber trick. He calls Cole up to the stage. Wrapped in chains, Finn is dropped in the tank but loses consciousness as soon as he enters the water.
Back at the hospital lecture hall, a bored House announces a contest for the Fellows. The winner will be spared from getting fired and will get to nominate two competitors. House will choose one from that pair to get the axe. Kutner suggests taking the case of the magician. He wants to run tests to find out why Finn's heart stopped in the water. House is sure the magician was faking. If Kutner is wrong, then he is fired. House declares that the contest objective is to retrieve a pair of Cuddy's underwear and bring it to the group. The Fellows debate taking the challenge. They will.
Thirteen helps Kutner examine the patient. Finn has her to pick a card from a deck and then asks Kutner for his wallet. He sets the wallet on fire. The card she picked is inside of it.
Taub and Amber conspire to obtain Cuddy's underwear. Amber tries to spill coffee on Cuddy, but that doesn't work. Then Amber smokes a cigarette to set off the fire alarm. Yet Cuddy stands with Taub away from the sprinklers and fully dry.
Kutner tells Foreman that the tests show there was no cause for the heart failure. Foreman suggests running a lung MRI. Finn suffers from internal bleeding. He has had three units of AB positive blood transfusions, so Thirteen considers that he has an intestinal infarct. She drops her files.
Taub enters the MRI unit with Cuddy's black panties. House, however, says that Cuddy is wearing a red bra. He deduces that Cuddy would be wearing red panties to match her bra. House asks Amber to lift her skirt. She refuses. House knows that Taub and Amber cut a deal. The black ones are Amber's.
While Finn is being operated on, House steps in and sticks his hand in Finn's gut. He pulls out a key. After Finn wakes, House informs him that the MRI magnet ripped it through his intestines. House tries to debunk him. The playing card that House chooses from Finn's deck is stuck to the glass wall. Finn refuses to tell House how he performs the trick. Suddenly, the magician starts to bleed profusely out of his nose. House realizes something is still wrong.
House gathers the Fellows in his office. He declares the underwear challenge is now off. Finn's cardiac arrest is actually a symptom of something more serious. Shockingly, Cole produces the panties. Amber proves that they're not hers, and then she suggests that Finn has Polyarteritis nodosa. Taub throws out the possibility that the nose bleed was caused by cocaine. House tells Taub and Kutner to go to the patient's home. He orders Amber and Cole to do a biopsy of Finn's heart. House tells Thirteen to come to his office. He thinks she is hiding a medical condition from him. She denies it.
Kutner and Taub find old arcade games, rabbits and marijuana in Finn's home. Taub theorizes that the rabbits could have given Finn pericarditis from a tick.
House demands to know how Finn did the card trick earlier. Finn performs a slight of hand with House's vicodin pills. They continue a discussion about knowledge of truth versus the magic of the unknown. House says it is better to know how things work and put all the pieces together. He diagnoses Finn with tularemia from his rabbits.
In the hallway, House drops his vicodin bottle so that Cuddy will bend down. He is amazed when he sees no panty line. He asks Cole to tell him how he was able to get her pants off. The Fellows interrupt because Finn now has bleeding around his heart. It could be cancer. House notices that Thirteen's hand is shaking. He tells them to find where the cancer is located.
As Cole gives Finn the MRI, Amber tries to influence his choice on who should be kicked out. Finn predicts that he will be dead by the next day. The doctors notice that Finn is bleeding inside all over.
Kutner considers a tainted blood transfusion. Foreman says that the low immunoglobulin levels and the other symptoms indicate amyloidosis. The Fellows' pagers go off at the same time. Finn has had a grand mal seizure. As Kutner and Cole attend to the patient, Kutner reminds Cole that he is his friend and should not be nominated for elimination.
While playing foosball, Wilson and House discuss how Cole could have gotten Cuddy's underwear. Kutner and Thirteen enter with the news that Finn has kidney failure. House believes that this proves the diagnosis of amyloidosis, and not a bad blood transfusion as Kutner suggested. House believes that Finn needs a bone marrow transplant. Wilson says that the patient needs to be irradiated first. House wants a subcutaneous fat biopsy taken and gives the Fellows two hours to check the blood theory.
Taub offers Cole $5,000 to not be chosen. In the hospital blood bank, House checks in on Foreman, Thirteen and Kutner's progress tracking the blood. Cole finds that the biopsy is negative. House wants them to next test Finn's organs. Yet Foreman no longer thinks it was amyloidosis. House wants to put the blood in his own body to see if it is tainted because he is the same blood type.
As Thirteen gives House the blood transfusion, he tells her that he saw a picture of her mother in her wallet. He explains that he Googled the obituary and knows her mother died from Parkinson's disease at young age. Thirteen admits that she may have inherited Huntington's chorea disease. House says that he has been switching her decaf coffee with caffeinated to see her reactions. Yet she refuses to be tested for the disease because not knowing her fate encourages her to live life fuller.
House falls sick from the blood transfusion and passes out. Thirteen tests his organs and admits that she spiked his tea. She leaves a bottle of water in the room. Wilson stops by House's office to see how he is. Wilson is type O, according to House. Wilson worries how House knows that. Did he test his blood? They realize that they gave the magician the wrong blood type. Finn tells House he is type-A blood. He is not AB, but his body is making an extra antibody of type B. That explains the symptoms after the transfusion. House says all the other symptoms point to Lupus.
House enters the lecture room with the underwear of Cuddy on a pillow. He asks Cole to nominate two candidates. Cole chooses Amber, the cutthroat bitch, and surprisingly, Kutner. House realizes that Cole made a deal with Cuddy to choose who she wanted out. In Cuddy's mind, Kutner's history of accidents means he is a liability to the hospital. House wanted someone to subvert Cuddy instead of dealing with her. He fires Cole.
Thirteen enters House's office with an envelope that contains her genetic test results for Huntington's. House had them performed from her DNA on the water bottle. Thirteen says that the not knowing is what gives her hope and that this is all she has to go on. House tosses out the unopened envelope into the trash.

House, MD Season 4 Episode 407: Ugly

A young girl screams on a train platform when she sees teenager Kenny Arnold’s grossly deformed face. Kenny’s father, Joe intervenes. They walk out of the station, followed by a documentary film crew. They are on their way to Princeton-Plainsboro Hospital for Kenny’s long-awaited cranial reconstruction surgery.
The film crew tracks Dr. Chase in the operating room as he preps Kenny for a facial bipartition. Kenny goes into cardiac arrest on the table. Cuddy, Chase and House are filmed discussing the case. Until they can locate the cause of the boy’s heart problem, the reconstructive surgery must wait.
The film crew must have full access to the doctors because they are paying for Kenny’s surgery. Cuddy thinks that this documentary will bring positive publicity to the hospital. House is concerned that the Fellows will be afraid to say the wrong thing on camera.
Dr. Terzi, the CIA doctor that House hired, is among the Fellows in the lecture hall. Amber harps on Terzi. House enters with the camera crew and they all walk down to a radiology room. Yet there is no metal allowed inside because of the magnetism so he is allowed to ditch the camera crew. House and the Fellows brainstorm about the case while an MRI is performed on a patient. Cole suggests that Kenny is using drugs. Discoloration of skin around his nose indicates huffing Freon. House orders a Nuclear Study to see if there is scarring on the heart. Terzi asks House if he definitely hired her. She gave up her job to be here.
House voices his concern to Wilson. He feels like he made a mistake about Terzi. She gave a poor answer in the differential.
Joe is angry when Taub suggests that his son is doing drugs. Kutner administers the nuclear test to Kenny. In order to lose the camera crew, House, Taub and Kutner review the test results in an operating room, dressed in scrubs. There is no scarring on Kenny’s heart. Taub insists that Kenny has increased intracranial pressure and would like to do a CT scan. House orders an EP study. Cuddy learns from the film producer that House has been ditching them.
Taub prepares the EP, threading a catheter into Kenny’s heart. Taub tries to get Kenny to admit he uses drugs when the patient starts to vomit blood. The camera films House and the Fellows in Cuddy’s office. The Fellows have spruced up for the camera. Kutner is wearing a tie and Amber has put on lipstick.
Taub and Cole are assigned to run a scope for stomach cancer although this test may cause Kenny to bleed again. Wilson jokingly tells the camera crew that House is a practicing Wiccan.
House admits to Wilson that perhaps he was blinded by Terzi’s beauty and he’s not sure if she is up to par with his other Fellows. House gets paged when Kenny starts to bleed from the scope. It could be a mitochondrial disorder, so Taub and Amber are sent to check for signs of retinal degeneration.
The camera crew captures Cameron in the ER with an uncooperative patient. She mixes up her words on camera and ends up saying that she loves Dr. House.
Amber fails to examine Kenny’s eye because his deformed head cannot fit into the slit lamp. Taub uses an ophthalmoscope and sees swelling. There is no degeneration. Taub argues with House about the causes. House decides it is Juvenile Rheumatoid Arthritis. Taub goes behind House’s back and tells Joe on camera that he will have House tossed off the case.
In Cuddy’s office, House and Taub debate. The father refuses putting Kenny on steroids. House fires Taub and wonders why he even took this job. Cuddy intervenes that no one will be fired in the middle of a case. She orders a CT scan to see if there is a midline shift. Foreman and Taub do the test.
House goes to Taub’s old practice and pretends to be a patient in for a plastic surgery consult. He is there to glean information about Taub.
Taub waits in House’s office with the scans of Kenny’s head. House and Taub show Cuddy the films. House says that he talked to Taub’s wife. Taub admits that he had an affair with a nurse and when his partners found out, he resigned. Cuddy doesn’t see anything on the scan and tells House to start Kenny on steroids for JRA. She also orders Taub to stay away from Joe.
House tries to convince Kenny to start the steroids. Kenny does not like House and only trusts Taub. House thinks the reconstructive surgery will kill Kenny. The father insists that Kenny needs the surgery.
Later that night, House enlists Wilson’s help in covertly obtaining the documentary crew’s footage to see Terzi up close. Wilson agrees that she made mistakes in the differentials. Cameron wants to fix her comments that she made earlier about House.
Taub shows House the slides again and points out a mass. House concurs with the diagnosis, and they pay a visit to the patient. Kenny is feeling better, but House notices Kenny’s pinky finger twitching. Something is off. There needs to be a better diagnosis. Thirteen comes up with Lyme Disease. He displays all the symptoms, except a target-shaped rash associated with the disease. Taub suggests a test to check whether House was right. If Kenny’s pacing wire is removed and his heart beats fine, then he can have his operation. If House is correct, then Kenny’s heart will stop.
The wires are removed and Kenny’s heart is in order. He can have the surgery. As Kenny is prepped in the OR, Thirteen tells the camera crew that if House is right then something bad will happen. She notices on the scans that there is discoloration around Kenny’s nose. Thirteen alerts House and stands by her Lyme Disease diagnosis. House dismisses this because there is no sign of the target rash. However, he acknowledges that no one examined him close enough. Chase shaves Kenny’s hair and the rash is there.
In the lecture hall, Taub discloses that he withdrew from his practice in order to keep his partners quiet about the affair. House decides to keep Taub and let Terzi go. House and Cuddy watch a copy of the documentary in which House is edited to look like a hero. House is annoyed and leaves. Yet Cuddy sees the ending as a post-operative Kenny thanks House.

House, MD Season 4 Episode 406: Whatever It Takes

Female drag racer Casey Alfonso preps for a race. Her crew chief is her father, Lou. As Casey maneuvers the dragster on the track, her eyes begin to blur. She manages to regain control and win the race. At the finish line, a reporter interviews her. Casey’s eyes blur once more and she passes out.
House and the Fellows debate whether to take on the case. Foreman suggests that Casey only had severe heat stroke. A federal agent enters and asks for Dr. House. The CIA wants him to consult on a case where an operative might have been poisoned. The agent leads House to a helicopter waiting on the hospital roof.
Brennan and Foreman tend to Casey. Foreman tells the patient that, while she is only dehydrated, they will run another cat scan to be sure. He calls House, who is aboard a private jet. House tells Foreman that he is on a mission for the CIA and he suggests that Casey has Miller-Fisher inflammation. Thirteen comes up with the same diagnosis.
Casey suffers a seizure. She is angry that the doctors cannot make a clear diagnosis. Foreman apologizes to her and she falls into a fever induced delirium. The Fellows debate whether Casey shows signs of MS or Lupus. Brennan and the others challenge Foreman.
At the CIA hospital, House meets a beautiful doctor named Samira Terzi. The CIA has also brought in Dr. Curtis, another consultant from the Mayo Clinic. House is not permitted to know about the CIA patient’s background but “John” is clearly unwell and suffering.
All Dr. Terzi admits to knowing is that John has been in Bolivia and his file says that he ate chestnuts. House does not believe that John has been poisoned. He thinks it is pancreatitis. Dr. Curtis argues that John has radiation poisoning, and John is started on treatment for it. House insists that John is hiding that he drinks.
House switches John’s medicine to treat pancreatitis instead of radiation poisoning. However, John’s progress deteriorates and he falls unconscious. Dr. Curtis admonishes House for his misdiagnosis. House now believes John suffers from Waldenstrom’s, a rare blood cancer.
Back at Princeton-Plainsboro, Casey’s lab results indicate the possibility of both MS and Lupus. Foreman leans toward MS, but Amber and Taub secretly consult Cameron about the Lupus. Foreman is angry when he finds out that Amber and Taub start treating Casey for Lupus, approved by Cameron. This is in addition to treating the patient for MS. They rush into the patient’s room when she says she cannot feel her legs.
Foreman argues that Taub and Amber’s steroid treatment could have overloaded Casey’s system and made her legs paralyzed. Taub suggests botulism. Brennan argues for polio even though there have been no U.S. cases for decades. This is similar to the polio cases he has seen in the Third World. Foreman clashes with Brennan and starts treatment for Botulism.
Cameron finds Foreman waiting for her in the ER. He has dismissed her patient. Although he really did not do that, she knows he only said it to let her know how it feels to have another doctor interfere in a case. When Cameron complains to Chase, he tells her that she needs to let go of working with House. The Fellows test food from Casey’s refrigerator for Botulism. Brennan wants to check for Polio.
House calls Wilson to consult on John’s cancer. Wilson doesn’t believe that he is really at the CIA. House offers Terzi one of his fellowships. John is feeling better, but when his hair falls out, House realizes he may be wrong about the diagnosis. Dr. Curtis chastises House and Terzi. House suggests an herbal treatment.
Brennan brings his test results to Foreman -- Casey has polio. Cuddy asks Wilson where House is. She doesn’t believe him and assigns the doctors extra clinic hours.
Foreman apologizes for being stubborn about Casey. Brennan advises administering high doses of Vitamin C. Brennan and Foreman tell Lou about the vitamin remedy.
House also gives John an unorthodox treatment derived from Chinese herbs. As he tells House that he spent forty days of Carnival as an attaché to a female government minister, House realizes that Carnival in Bolivia only lasts eight days. John was in Brazil, not Bolivia. He ate too many Brazil Nuts. The selenium in the nuts caused his illness.
Casey feels her legs again. The protocol of Vitamin C worked. Foreman is stunned. Cameron supports Foreman and admits that she misses the thrill of working with House.
House leaves the CIA hospital, smitten with Dr. Terzi.
The next day in the lecture hall with the Fellows, Foreman brings Casey’s file to House. Casey is free of polio because she never even had it. House describes the scenario: Casey had symptoms that seemed like polio because she was poisoned with thallium and then was apparently cured with Vitamin C. Brennan did this to her in order to obtain research for curing polio in the Third World. Foreman was right -- it simply was severe heatstroke.
House won’t fire Brennan and he makes him quit instead. He tells the Fellows to listen to Foreman. Cuddy asks House where he has been. At first she believes the lie he gives her, but then doubles his clinic hours in doubt. Dr. Terzi is waiting for House at the Princeton-Plainsboro entrance. She wants to take him up on his offer. House thinks she is flirting, but what she means is she is accepting the Fellowship offer.

House, MD Season 4 Episode 405: Mirror Mirror

As a man in his thirties walks along the street, he is mugged by two young men. Although the man tries to defend himself, he starts to become very sick. One of the hoodlums uses the man’s phone to call 911.
At the hospital, House is lecturing the Fellows that the victim’s respiratory failure is like a “cat burglar.” Cuddy walks in with Foreman to show House that he has returned. Cuddy tells the remaining Fellows that Forman will be her eyes and ears. House announces that he will now make Foreman miserable. Forman responds that he already is.
The mugging victim who suffers from memory loss has no ID on him, so the doctors name him “Mr. X.” Amber and Brennan stress the patient on a treadmill, which causes him to have abdominal pain and tingling limbs. The team tries to unify the symptoms including laryngospasm.
Chase takes bets on which Fellows will get fired. Forman wants to quit but no one will hire him now. House plans to humiliate Cuddy until she fires Foreman. Suddenly, the patient crashes. Lying unconscious on the floor, Mr. X is wearing a doctor’s coat. Forman thinks he must be faking. He might be suffering from Munchausen’s Syndrome and copying the symptoms of neighboring patients. House deduces that it is actually Giovannini Mirror Syndrome, where one innocently picks up the attributes and senses inner thoughts of others to cope with memory loss.
To prove that X is not faking, House has the man join him in a surgery. In the operating room, X is about to perform a surgical cut on the patient when House stops him. House pulls off X’s glove, slices his hand and finds that the blood is frozen. House knows the man cannot fake that.
On the way to the cafeteria, House tells the Fellows that the effect of the temperature change on X’s blood requires testing for an infection. He will need an ultrasound, blood cultures and a medical history. In order to punish Cuddy for hiring Foreman, House announces that there is tainted mayonnaise in the cafeteria. He suggests every customer go complain to Cuddy.
They requires some clues from X’s life. With the patient’s car key, House sends Cole and Thirteen to search X’s car. Amber draws blood from Mr. X and he mimics her. She gets a look at herself through his eyes. Taub performs an ultrasound and X emulates him as well. Taub finds a lesion on his liver.
Wilson informs House that Giovannini patients mimic whomever they think is in charge. Cuddy sends the Fellows to the clinic to treat the hospital cafeteria’s food poisoning victims. House comes to the clinic to retrieve his doctors and asks them about the liver lesions. He then calls out tests for all the uninsured patients in order to upset Cuddy.
Brennan gives Mr. X an ultrasound and finds fungal black pus. This is just like what he found in survivors of the recent tsunami. Brennan tells House that Mr. X has helped him realize that he wants to go back overseas. House rejects this. Amber and Kutner discover that Mr. X is covered in a rash. They put him in a whirlpool to circulate his blood.
Brennan is wrong about his career change and the fungus. Antibiotics are not working, so House needs more information on the patient. Thirteen and Cole search for the car but it has been towed. They drug the guard dogs at the tow yard.
House wants more blood cultures and more accurate patient history. The Fellows respond to House over Forman. Forman turns to Cameron, who insists that he belongs with House. Kutner takes spinal fluid from X to find the places the man has lived. In mimicking Kutner, X says that he likes hot tubs. Wilson catches Cuddy switching House’s pills with laxatives. Wilson advises her to play up to House’s ego instead.
Mr. X’s spinal fluid shows he has been to Ohio, California and Central America. Although he complains of having laxative “issues,” House suggests heating X from the inside with medication to cause overheating by inducing a high fever. Forman follows him into the men’s room to challenge this.
Cuddy feigns protest to the treatment in order to get House to think he has won. House sees through her charade and says that he knows his pills have been switched. He then lets it slip that perhaps her birth control pills have also been swapped. While Forman attends to him in the hot tub, Mr. X mirrors Foreman. He collapses from the heat. The doctors dry the patient off and Kutner uses the paddles on him to induce cardiac arrest. Kutner shocks himself because X is not completely dry.
Mr. X continues to suffer, and the team tries to figure out the cause. Foreman thinks there is an infection in his heart which requires a biopsy. House informs Foreman that he has set up another job for him, but Foreman declines. Thirteen and Cole return with items from the patient’s car. Knowing that Thirteen didn’t want Mr. X to mirror her, House tries to get the man to imitate her. Yet X instead responds as House. Kutner failed to report that X had a memory about himself in the hot tub. The rash returns.
House dresses in Mr. X’s clothes and reflects back to himself using things from the car in order to get X to reveal more about his life history. X uses the vapor rub found in the car to mask the smell of “dung.” House realizes the problem. Mr. X is a farm equipment salesman from Ohio and has contracted an infection from pig feces called eperythrozoon.
Before they start treatment on the patient, Foreman wants X to do one more thing. House and Cuddy present themselves to X to see who is more dominant. Wilson, Foreman and the team watch. Wilson tells Foreman that House was lying about the job. Mr. X observes and mimics House and Cuddy. House is the more dominant. Flush with victory, House lets the team know that none of the Fellows are fired because they all made mistakes. Chase wins his bet. Foreman is aware that Chase was splitting his winnings with House, which is why no one is fired. Foreman is staying.

House, MD Season 4 Episode 404: Guardian Angels

Working alone in a funeral home’s prep room, Irene Walesa cuts the hair of a cadaver. As she pours herself a cup of coffee, she has a feeling someone alive is in the room with her. She turns to see a man standing in front of her, ready to attack. Irene grabs a pair of scissors but the man takes them. Suddenly, the other dead bodies are also attacking her. She calls out for help, but she is choking and gasping. When a co-worker arrives, he finds Irene on the floor having a grand mal seizure as if someone were shaking her. The corpses she thought were alive still lay dead on the tables.
The remaining Fellows wait for House in the lecture hall of the hospital. Amber tries to suck up to Thirteen, but she is interrupted when the phone rings. House is calling from his office. Cameron enters with news about Foreman being fired from Mercy Hospital. She then accuses House of being extra hard on Cole. They make a one hundred dollar bet that Cole will confront House.
The fellows discuss Irene’s case, as Taub and Amber give the patient an MRI. Irene sees her mother is there to comfort her. Yet it is a delusion. Irene’s mother has been dead for a long time.
Foreman interviews for a new job. Meanwhile, Cole, Henry and Kutner search the funeral home for clues. Cole suggests that embalming fluid could have caused the seizure. House dismisses him over speaker phone. Although Irene is a vegetarian, she could have gotten a brain infection from one of the carnivore cadavers.
House orders the Fellows to dig up a corpse embalmed by the funeral home two years ago which could have had a case of Mad Cow Disease. Cole cannot go because he is a single father. Amber tries to curry favor with Cuddy by offering her assistance to the hospital clinic. Cuddy tells her to just do whatever House asks.
The Fellows unearth the grave to get a brain sample from the corpse. Amber arrives three hours late. The Fellows are annoyed with her, even though she has brought coffee and donuts. Amber continues to unnerve the very private Thirteen by asking personal questions.
Back at the Hospital, Cuddy questions House about the grave robbing. The test on the brain tissue does not support the diagnosis. Every suggestion that Henry makes is welcomed by House.
Cole, Amber and Thirteen are treating Irene when they realize that she is hallucinating that her dead mother is present. The Fellows struggle to diagnose her. Amber and Thirteen clash on how to react to Irene’s delusions. Irene mentions the imaginary guy in the wheelchair that she sees. It is Stark, the man that died under Thirteen’s watch.
Cuddy and Foreman meet in a restaurant to discuss the possibility of Foreman returning to work for House. Foreman resists, but Cuddy needs someone who knows how to handle House. Foreman attends another interview. Although it goes well, his actions at Mercy Hospital disqualify him from consideration.
The Fellows tell House that Irene saw Stark. They must find out how Irene’s mother died because only Irene believes her mother is still alive. House visits with the patient, and Irene claims to see Grandpa House in the room. House hides out in Wilson’s office to make Irene think that he believes her. He hopes to gain her trust so that she will divulge what her mother had. When House returns, he is able to talk to Irene about her mother. He deduces that Irene has inherited Parkinson’s Disease.
Irene has a psychotic episode imagining that Thirteen is attacking her arm with a needle. Thirteen sees that Irene’s arms are covered with red welts. The Fellows lean toward a diagnosis of vasculitis, which restricts blood flow to nerves and electrical function.
Cameron advises Cole to stand up to House because he will respect that. She then goes to House to discuss Cole.
Amber and Thirteen are checking Irene’s eyes when a dog collar appears on a table. Irene becomes sickened from the eye exam and vomits up blood. Chase and Cole perform intestinal surgery on Irene’s enlarged spleen. They notice that her liver is severely damaged. House instructs Cole and Brennan to perform a visceral angiogram. Cole is saying a prayer over Irene when she grabs his inner thigh lasciviously. Cole is alarmed, and Irene suffers another seizure.
The Fellows go to consult with House. He debates with Cole about his religious and scientific convictions. House provokes Cole to the point that he punches him. The discussion about historical cases of persecution makes Amber realize what is wrong with Irene. She has Ergot poisoning from moldy bread. The organic rye bread she eats has caused the hallucinations and symptoms similar to those displayed by young women burned at the stake as “witches.”
Amber and Thirteen treat Irene, and her illusion of the mother disappears. House has to let one of the Fellows go. He hands out peonies to all except Henry, who is actually not a doctor. Although Henry has offered ideas, they are ones that House has already thought of. The team is necessary to come up with new, fresh ideas.
Cameron collects her winnings from House’s bet on Cole. Foreman comes to see Cuddy and accepts her offer to return, but he has a few requests. Cuddy rejects them because she knows that his options are limited. She is the only one that will hire him.
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House, MD Season 4 Episode 403: 97 Seconds

Thomas Stark, a young man in a power wheelchair, and his English Shepard service dog, Hoover, exit a minivan. Stark begins to motor himself across the street when he suddenly loses consciousness. Hoover reacts as cars approach. A driver that is changing her radio station dial is unaware of the impending crash. She hits the breaks just in time. The woman runs out to check on the young man slouched in his wheelchair in the middle of the road.
At Princeton-Plainsboro, House arrives in the lecture hall to describe Thomas Stark’s condition to the remaining Fellows. He wants to split the candidates into two teams to investigate the condition. Twin 15B suggests women be pitted against men. Amber asks to be on the men’s team to increase her chances of being selected. Yet the guys resist because they hate her. The men and women discuss options for diagnosis. Kutner suggests that the patient’s recent trip to Thailand had something to do with his illness.
Amber approaches Cameron in the ER to get her help on the case. House attends to Mark Allmore, a young man who is bruised from a car accident. Suddenly, Allmore pulls out a knife and sticks it into an electrical socket, electrocuting himself.
Thirteen believes that Stark picked up a thread worm called Strongyloides while in Thailand. She gives him a cup with two pills and he asks for some water. Kutner and Brennan enter the room to perform tests on Stark. They carry him to the bathroom to collect samples. Cuddy asks House what is wrong with Stark. He really does not know.
House obsesses with Wilson about the man who shocked himself. House plays with the knife Allmore used.
Amber walks into the men’s team but she is unwelcome. She offers information from Cameron in exchange for entry onto their squad and they agree. Amber administers a test on Stark that involves a jar of bugs biting him. He starts to choke.
The Fellows and House discuss the new development. Thirteen insists that Stark has Spinal Muscular Atrophy and Strongyloides worms. Twin 15A thinks they need to stress Stark’s system. House penalizes the men with detention for only performing tests while the women actually tried to heal Stark.
Allmore tells House that he wasn’t trying to kill himself. He was only trying to re-experience the bliss of the 97 seconds he was technically dead caused by a car crash.
Amber and the men’s team deduce that a tumor in Stark’s neck could be the trouble. She sneaks out and finds Stark on a tilt table, where his vitals remain stable despite being swung like a human see-saw.
House has decorated the lecture hall like a tribal council. Amber enters holding a CT film that House dismisses. She then hounds Chase in the operating room to look at the scan. She convinces him to run a blood test on Stark for her. Amber takes the blood from Stark. It is the color green -- which is the unprocessed dye from the CT test. His kidneys are failing.
House is stumped. He was sure that Thirteen’s diagnosis of Strongyloides was correct. Amber stands by her theory of scleroderma. When he finds out that Chase helped Amber, House confronts Chase in front of the Fellows. House believes Stark really has cancer.
At Mercy Hospital, Forman is trying to diagnose a case with a team of his own but he is struggling. He’s accustomed to thinking “outside-the-box,” and he cannot find common ground with Schaffer, his new “play–it-safe” supervisor. Foreman comes to a decision about what to do. He pushes his patient’s bed in the hallway, literally taking things into his own hands.
Back at Princeton-Plainsboro, House wants to remove Stark’s eye because he believes this is the source of the cancer. This enrages Cuddy. Stark refuses the surgery. He does not want to live if it means not walking, not eating and now not seeing. House belittles Stark’s belief in the beyond to Wilson. Misery, he says, it better than nothing. House contemplates death and the afterlife in his office. He plays with Allmore’s knife and stares longingly at an electrical socket.
Amber and Thirteen attend to Stark’s lungs. He can barely breathe, and the liquid removed from his lungs is clear, not bloody. If he had cancer, there would be blood.
Amber is paged by House and she finds him lying unconscious on his office floor from electric shock. House wakes up in the same room as Allmore. Wilson takes over leadership of the Fellows.
Wilson lets House know that Allmore just passed away and that Stark probably has Eosinophilic pneumonia rather than cancer. Wilson prescribes House some extra pain meds. This, of course, pleases House.
Stark is near death. The Fellows assure him that the new medicine will work. He asks for his faithful service dog, Hoover.
After Stark dies, Amber brings the news to House and asks why he summoned her with the page. He explains that, if he died, she’d never get the job. He knew she wouldn’t let that occur.
When they get to Stark’s room, Hoover the dog is also dead. House asks Thirteen if she actually witnessed the patient take the pills for thread worm. She hesitates. The medicine is fatal for dogs like Hoover with the MDR1 gene. House finds the empty pill cup on the floor. There are dog teeth marks on it.
At Mercy, Foreman’s unorthodox treatment works for his patient. Yet his supervisor Schaffer is unhappy. She does not tolerate bending of any rules. Schaffer fires Foreman on the spot.House meets with Thirteen. Her initial diagnosis was correct -- Stark would have lived had he taken the pills. She begs to be spared the lecture and for him to just fire her. Yet House is giving the lecture because he is not firing her. He knows Thirteen will never let something like this happen ever again.

House, MD Season 4 Episode 402: The Right Stuff

A female Air Force pilot named Greta flies a Stealth fighter jet with precision over a desert landscape. She begins to perceive sounds for the flight rather than visuals. She heads for a crash into the mountainside. Greta is actually in a virtual reality flight simulator inside a warehouse. Angry and confused, she blames the controller for her crash.
In the hospital lecture hall, House asks the Fellowship candidates to identify the man on the screen behind him. It is the actor Buddy Ebsen, who was diagnosed with an allergy to aluminum dust in the make-up used on him as the original Tin Man character in “The Wizard of Oz.” House dismisses the group to investigate the allergy. Cuddy comes to the door to tell House he’d better start eliminating candidates. House proceeds to fire the entire Row C. Yet when a pretty applicant goes to leave, House changes it to Row D instead.
House gets a page from his own pager number. He enters his office to find Greta waiting. She offers him fifty thousand dollars in cash to diagnose what is wrong with her. It appears that she is seeing with her ears, and she hopes to keep this fact from NASA and the Air Force where she is a candidate for astronaut training.
House brings the case of synesthesia to the remaining group of applicants and tells them to keep it a secret. He assigns some candidates to perform different tests on the patient. Another group is sent to break into Greta’s home to find out what she is hiding. He tells the rest of the candidates to wash his car.
While candidate Jeffery Cole washes House’s car, the others assigned to it complain. Amber Volakis has them all stop, and she takes the car to a carwash with Cole.
The trio designated to break into the patient’s home also complain. Henry Dobson, a candidate far older than the others, manages to break into the apartment and outsmarts his younger colleagues.
Candidates Taub, Jody and “Thirteen” report back to House that the patient has an elevated red blood count. A group of doctors walk past House’s office and he notices that one looks very much like Chase. House decides that the cause of Greta’s problem must be carbon monoxide poisoning from her fireplace.
When Amber returns from the carwash, House has her put the patient into a hyperbaric chamber. In the chamber, Greta suffers a heart attack from the oxygen therapy. The doctors try different methods to save her. When they hit her with defibrillator paddles, Greta is set on fire.
House asks the doctors what could have caused the heart attack. Henry suggests a cardiomyopathy, and House tells him to do a transesophageal echo. He orders the rest to go document ten things that cause infection in the hospital cafeteria. House tells Wilson that he saw Chase. Wilson thinks it’s only an illusion, and he attributes it to House’s guilt because Chase and Cameron are in Arizona.
Henry hesitates inserting the endoscope into Greta and gives it to Thirteen to do instead. The Fellows follow House down the hallway to update him. He recommends a test for hyperthyroidism. While candidate Chris Taub administers the test, the patient has a panicked reaction when she finds out that they had been to her home. Greta runs out of the room and locks herself in the hospital chapel. As the Fellows try to reason with her, House arrives. He notices someone who looks like Cameron but with blonde hair. Cuddy comes upon House to ask the identity of the mystery patient in her hospital. She admonishes him about running everything past her.
House checks in with the team, and they decide that the patient suffers from liver cancer. House asks Wilson for advice on how to test Greta. Lawrence Kutner, who was eliminated as number 6 has returned with his number upside down as a 9. Kutner provides the answer: they should get Greta drunk and measure her response. House chooses Cole, a Mormon who does not drink alcohol, to be the control group.
While feeding Greta shots of tequila, House thinks that he sees Forman walk by. He chases him down the hall. By the time House returns to Greta’s room, she has disappeared. Cuddy chastises House for the unorthodox tests he is doing. She takes a whiff of him and asks if he has been drinking.
With Cole and Thirteen, House examines Greta’s belabored breathing and concludes that she has lung cancer. Greta refuses surgery, fearing that NASA will see the scars it will cause. House consults the Fellows. Since Taub is a plastic surgeon, he suggests breast implant surgery to mask the scars. Prior to surgery, Cuddy asks House to explain why the patient is undergoing cosmetic surgery. He says it is in the best interest of the patient.
During the surgery, the team finds cysts on Greta’s lungs. House calls out to the doctors for a diagnosis. He hears someone in the viewing gallery give the correct answer -- Von Hippel-Lindau Syndrome. That person is Chase. House is unsure if this is another vision but then realizes it is not. Chase has joined the surgical staff of the hospital and he was really in the hall.
House confronts Wilson who knew all along that Chase returned from Arizona. Cameron now works downstairs in the emergency room of Princeton-Plainsboro. Forman is at New York Mercy Hospital.
Greta awakes from surgery and still insists on not telling NASA. House lets her know that he told NASA himself.
House is in front of the candidates in the lecture hall and announces his selections. In the hallway, he addresses the eldest candidate, Henry. House says that he knows Henry did not attend medical school. He offers him the position of assistant.
House approaches Cameron in the ER. He says that he had lied about telling NASA of Greta’s condition. He couldn’t kill her dream.

House, MD Season 4 Episode 401: Alone

When a gas main explodes, a young woman named Megan Bradberry is buried beneath a collapsed building. Severely injured, her face almost unrecognizable, Megan is rushed to a hospital, where she undergoes a tracheotomy and is placed on a ventilator. Cuddy is puzzled by one aspect of the case: Megan is suffering from an unexplained fever. House isn’t interested in the case, as he doesn’t have a team. When Cuddy orders him to take the case, House says he’ll do it on his own, provided she goes away for a week if he makes the correct diagnosis.
As House mulls over the facts in Megan’s case, he talks out loud, as if his team was in the room with him. He then bounces ideas off the janitor, Leon, and eventually concludes that the fever was triggered by an infection. Dressed in a lab coat, Leon accompanies House to Megan’s room. There, House interviews Megan’s boyfriend, Ben, and her mother, hoping to discover what might have caused the infection. When that avenue dead-ends, House and Wilson break into Megan’s residence to look for clues. House finds Megan’s secret diary. Inside are entries describing her depression. House suspects Megan has been taking anti-depressants which, in combination with the drugs she’s being given at the hospital, produced the infection. At the hospital, House convinces Ben and Mrs. Bradberry that it’s in Megan’s best interest to be placed on dialysis, even though both of them refuse to believe she’s secretly been taking medication for depression.
When House returns to his office, he discovers that his prized guitar has been kidnapped. He suspects Wilson is to blame, but Wilson denies it. Meanwhile, Cuddy asks Megan a series of questions. Since Megan is unable to talk, Cuddy instructs her to blink once for “yes” and twice for “no.” Suddenly, Megan’s heart rate soars. Cuddy is forced to use defibrillator paddles to return Megan’s heart rate to normal.
House and Cuddy are now faced with two unexplained symptoms: fever and tachycardia. House proposes a second explanation for the illness: the DTs. Ben dismisses the idea as nonsense; he knows Megan isn’t an alcoholic.
Convinced that Wilson stole his guitar, House shows up to Wilson’s hotel apartment and begins erasing his beloved telenovelas. Meanwhile, at the hospital, Cuddy realizes Megan is silently screaming.
Cuddy tells House that Megan has developed pancreatitis. House attributes the development to the IV alcohol being used to treat Megan DTs. Later, Wilson reacts with mock revulsion when he pulls the tremolo arm of a guitar out of a package mailed to House. He tells House that the kidnappers mean business. House insists he’s not hiring a team to help him diagnose cases.
An MRI shows no abnormalities on Megan’s pancreas, but House realizes she’s bleeding internally. House enters the operating room where Megan is undergoing surgery. He examines Megan’s uterus with the help of an endoscope. It shows she recently underwent an abortion. This leads him to conclude that Megan was taking birth control pills. A short time later, House meets Doug McMurtry, whose girlfriend, Liz Masters, was working with Megan at the time of the explosion. Doug tells House that Liz died from her injuries.
House tells Ben that Megan had an abortion and is on birth control medication. Ben insists this isn’t true, as they both wanted kids. House places Megan on tamoxifen, an anti-cancer drug, to block estrogen receptors. Cuddy relays word that Megan is now experiencing breathing difficulties and her kidneys are failing.
A young doctor suggests to House that Megan is suffering from ARDS and Crush Syndrome, both reactions to severe trauma. The problem is, there’s nothing doctors can do to save her. House gives Ben and Mrs. Bradberry the bad news. Yet House notices a lump on Megan’s arm. It turns out the lump was triggered by an allergic reaction. Ben and Mrs. Bradberry insist the allergy diagnosis doesn’t make sense.
Still convinced that Wilson stole his guitar, House moves one of Wilson’s cancer patients to another room in the hospital. Wilson confronts House, and warns of catastrophe should the patient be given the wrong medication. House thinks about this for a moment -- and makes a connection. House makes his way to Megan’s room, where he tells Ben and Mrs. Bradberry that the girl on the bed isn’t Megan. It’s Liz Masters. Both women have the same build and hair color. This explains why nothing added up in terms of a diagnosis: House had the wrong patient. Unfortunately, it also means that Megan is dead.
Cuddy orders House to assemble a team. Later, as House twangs his guitar, he addresses a group of candidates.

House, MD Season 3 Episode 324: Human Error

A Coast Guard helicopter hovers over the ocean. A Cuban refugee named Marina Hernandez sits in the cabin, wrapped in thermal blankets and shivering from hypothermia. An officer struggles to save her husband Esteban from the choppy water below, but Esteban refuses to let go of Marina’s suitcase. With the chopper running low on fuel, the officer dunks Esteban which forces him to release the suitcase before pulling him to safety. On board, Esteban screams in Spanish that Marina’s medical records are in the suitcase and that Dr. House needs to see them. Esteban watches helplessly as the suitcase floats away.
Cuddy tries reaching House, but he is no longer answering his cell phone because he has become “world famous.” Instead, House watches from a distance as Foreman attends a going-away lunch with the nursing staff.
Later, Chase and Cameron go over Marina’s admission exam while Foreman checks his email. House saunters in to see where they are. Since Fidel Castro emphasizes medical care in Cuba, House figures that Marina has already been filled with antibiotics. He rules out simple diseases like parasites or infection and requests an MRI. He also wants the team to check Esteban for any symptoms caused by being stranded at sea. They can subtract those from Marina’s list.
Chase observes that Foreman isn’t going to leave. This piques House’s interest. Chase thinks Foreman doesn’t want to leave and that House doesn’t want to let him leave. He assumes House will cave, just like he did with Cameron. Foreman obviously wants something from House, so Chase suggests he try telling Foreman what he wants to hear.
Foreman discovers that Marina has Multiple Sclerosis. They should start her on interferon and see if she improves. Esteban complains that Cuban doctors would have spotted MS. Marina cries in pain. When Foreman rotates her forearm as a test, her bones snap in a spiral fracture. House suspects bone cancer because metastatic tumors would explain the abnormal MRI, kidney damage, cotton mouth and double vision. House orders a PET scan to see what else the cancer is breaking. Convinced it’s not cancer, Chase argues that House is stupid to think that Foreman will forget the last three years and stay there if House starts agreeing with him. House ignores him and again asks for the PET scan.
Chase finds House in his office and starts talking about Foreman again. House cuts him off and fires him. He explains that Chase has been there the longest. Either he has learned all he can or hasn’t learned anything at all. This means that it is time for a change. A stunned Chase shuffles out of the office.
Foreman and Cameron perform the PET scan but don’t find any signs of bone cancer. Chase comes in to break the news that he has been fired. Suddenly, Chase sees a hotspot by Marina’s humerus on the scan.
Cameron and Foreman barge into House’s office, demanding to know why he fired Chase. Then Cuddy enters, kicks out Foreman and Cameron and asks the same question. She orders him to rehire Chase. House calls Chase and asks about Marina’s PET scan. Chase says that there is a blood clot in the arm. House doesn’t hire him back.
Foreman informs Esteban that Marina will need an angiogram to confirm the presence of a clot. Esteban demands to see House, but he has left for the evening. Foreman gives Esteban House’s phone number and instructs him to keep calling because House doesn’t always pick up. Foreman smiles at his prank.
The next morning, Foreman and Cameron perform the angiogram in the middle of arguing about Chase’s firing. An exhausted and angry House comes in, questioning whether Foreman gave Esteban his home number. After he leaves, Foreman marvels that House would stay up all night listening to the phone ring rather than talking to a patient for five minutes. Cameron notes that a trick like that makes Foreman worse than House. All their bickering stops when Marina goes into V-Tach. Although her EKG flat lines, Marina keeps talking to them. She loses consciousness and the doctors begin CPR.
The doctors are still working on her three hours later. They have yet to start bypass surgery because House fears the clot will break loose and head for the brain. Foreman explains the situation to House and Cuddy together. Cuddy immediately okays the bypass. As the doctors rush Marina into surgery, Esteban finds House relaxing in his office. House is disinterested, but Esteban emotionally pleads that he looked him up because he has a reputation for fixing people when other doctors have given up. Esteban questions why House is just sitting there and not tending to Marina. House thinks for a moment and then heads into the OR.
House has the surgeon turn over Marina’s non-beating heart but there is nothing physically wrong with it. He asks the surgeon to shock the heart, but seven attempts don’t revive it. The surgeon is merely keeping bypass going until Esteban can say goodbye. Marina’s heart simply won’t start. She’s dead.
House retreats to his office in an attempt to figure out why the heart won’t start while the bypass is still keeping Marina’s brain alive. Cameron and Foreman argue that it’s over, but they realize House doesn’t want to tell Esteban because that will mean House failed.
Cameron goes to meet Chase at a nearby bar. She tells him that everything will work out in the end, but Chase has already come to grips with the firing. He figures it probably is time for a change.
Late that night, Cuddy finds House in his office and asks when he plans on telling Esteban that Marina is dead. Cuddy wonders whether House was hoping for a storybook ending, but House argues that he honestly doesn’t care. He just wants to know what the problem is. House tracks down Esteban in the chapel and informs him that nothing seems to be working. He can say goodbye to Marina before House removes her from bypass.
Esteban apologizes to his wife, kisses her one last time and House begins shutting off the machines. Esteban leans down to hug his wife and feels her heart beating. House explains that it is just residual blood flow. Esteban grabs House’s hand and places it on Marina’s heart. House flicks on the EKG and sees that her heart is beating normally. Her eyes open and she regains consciousness. House is shocked. Esteban thinks it’s a miracle.
Three hours later, Foreman reports to House and Cameron that Marina is still stable. Her blood pressure, EKG and kidney function are all normal. House thinks about the angiogram and wonders if human error wasn’t to blame. Maybe it was divine error. A congenital heart defect in an artery would be susceptible to inflammation. This causes arrythymia, which causes angina and clots. They will need another angiogram to be sure.
The procedure begins and House injects the dye into Marina’s heart. The right and left coronary flow both look normal, which makes House worry that this test is about to go bad. Cameron spots something odd on the monitor. Marina has a third ostium. Humans should only have two. This third one is causing inflammation, is becoming infected and sending out clots. This is everything that has been plaguing Marina. After one more surgery she should be fine.
That night, Chase opens his apartment door to find Cameron on his stoop. They kiss and head inside.
Wilson meets up with House in the doctor’s lounge. Foreman enters and the room freezes. House says he wants Foreman to stay on because he is an important part of the team and he needs him. Foreman agrees, but says he doesn’t need House. House tries to argue that he just solved a case by predicting a never-before-seen heart defect even though Foreman gave up on it. Foreman points out that House is only happy for now. Soon he will be jonesing for the next case to come along. Foreman doesn’t want to solve cases. He only wants to save lives. House becomes angry, and yells that Foreman only cares about himself and his ego. This is the reason he dragged out his quitting over three weeks. Foreman looks at House and then simply walks out.
House retreats to his office. Cameron is waiting for him with her resignation letter. House asks if she expects him to break down and ask Chase back. Cameron smiles and says she expects House to make a joke, move on and be just fine. But she says she will miss him.

House, MD Season 3 Episode 323: The Jerk

Sixteen-year old chess prodigy Nate Harrison easily mows down an older opponent while mocking his moves. Afterwards, the opponent offers Nate a handshake and congratulations. Nate winces and begins breathing rapidly. He picks up the chess clock and smashes it in his opponent’s face. Nate jumps on the man, pounding him with punches until proctors are able to drag him away. Nate holds his head in agony, fighting for breath.
As Chase examines Nate in the hospital, the boy’s mother Enid stands at his bedside. Nate is sarcastic and difficult to him. Chase ignore his jibes and presses on with the exam. Chase presents the case to the team. He says that the boy is dealing with rage and head pain, plus various bumps and bruises from the seventeen fights he’s been in this semester alone. House adds “personality disorder” to the list of symptoms. Suspecting that the diagnosis is cluster headaches, House asks them to start Nate on blood thinners and he prescribes Transcranial Magnetic Stimulation.
Foreman performs the procedure on Nate, who continues to be obnoxious. Outside, Chase explains to Enid that cluster headaches often cause irritability or hostility. If they are right about the prognosis, then treatments could change Nate. This delights Enid. She had thoughts that she was a bad mother because she hated Nate.
The next morning, the team explains to House that the blood thinners and TMS had no effect. They rule out cluster headaches and now suspect hemochromatosis or hypothyroidism. House quickly shoots down both conditions because they don’t match Nate’s personality issues. House sticks with cluster headaches, arguing that symptoms never lie. Cameron points out that the only approved treatment left is brain surgery, which is not a guarantee. House smiles, noting that they will be forced to use an unapproved treatment.
When the meeting ends, Foreman storms out. He tells House that he had an interview lined up for the day before at New York Mercy Hospital, but they said he cancelled. Yet he never called them. Foreman accuses House of going behind his back and questions whether he has a neurological issue. House claims innocence, coldly explaining that he only sabotages people he deems worth the trouble.
House congratulates Cuddy on her cunning move of canceling Foreman’s interview. Cuddy firmly informs him that it wasn’t her but that she is awaiting board approval to make Foreman an offer to stay. House asks permission to give Nate mushrooms to treat his cluster headaches because the psilocybins in them work on the headaches. Cuddy only permits a low dosage of less than ten milligrams given in a tightly controlled setting. House also must obtain parental approval.
Chase and Cameron administer the drugs and then observe Nate. He is not feeling any pain in his head but rather the opposite. Cameron says that this confirms a diagnosis of cluster headaches. Nate then invites Cameron to have sex with him and he lifts up his blanket. The doctors see that his testes are undersized but that his other sexual characteristics are normal. They turn their focus to the hypothalamus. House orders Chase and Cameron to biopsy the pituitary.
Enid is all for the procedure but Nate refuses to have his brain cut open. Suddenly, Nate becomes disoriented and blacks out. Chase notices that his gums are yellow and realizes that Nate is jaundiced. The liver is shutting down. Chase and Cameron start the patient on sodium polystyrene sulfonate.
The boy’s liver is operating at around twenty percent and deteriorating fast. It’s possible that the liver failure caused the other symptoms, but what caused the liver failure? Foreman gets a page. House assumes it’s from Cuddy and excuses Foreman to handle his business. Chase mentions that Nate was raised a vegetarian but then started eating meat a few months ago. House observes that, with an OTC deficiency, Nate wouldn’t be able to metabolize the nitrogen and this would damage the liver. He orders the doctors to stuff Nate full of meat and wait for his ammonia levels to spike.
Cuddy presents Foreman with a deal to double his salary and put him in charge of his own diagnostic group. He would work parallel to House but have complete autonomy. Foreman thinks about it and then quickly declines. Since somebody at the hospital sabotaged his interview, he can no longer work there.
Chase and Cameron bring Nate a giant platter of hamburger patties. He demands a higher quality meat and won’t eat them. Chase snaps. He threatens to strap Nate down and force the meat into his system. Nate backs down and takes a bite.
Cuddy accuses Wilson of killing Foreman’s interview in order to help House. Wilson says he hopes Foreman will leave so that House realizes he needs another doctor to stand up to him. Cuddy doesn’t believe him, labeling Wilson an enabler. Wilson calls Cuddy paranoid.
The hamburger test shows no change in Nate’s enzyme levels, meaning he is not affected by OTC deficiency. House’s next idea is to starve the boy because diabetic steatosis will screw up the liver, which will allow them to see if the blood sugar pops. Chase warns that messing with Nate’s blood sugar could set off another rage.
The changes do cause Nate to rage, and the doctors find him jaundiced in his room. Nate is swinging around his IV pole and threatening the nurse and his mother to feed him. The doctors tell Nate that once they get a urine sample he can eat. Nate defiantly pees on the floor. Yet his urine changes from bright yellow to blood red.
A chem panel confirms that the bloody urine is due to kidney failure. Nate is put on dialysis, which he will need for the rest of his life. Now the team is stuck for answers. Foreman throws out hepatic fibrosis or MCADD. Considering that it might be a genetic disorder, House asks them to acquire the sequencing primers and figure out if it’s one of the genetic diseases they can actually fix. Foreman announces that he has to leave and House questions if he’s going to a job interview. Foreman wants to know whether House will stop him if it is.
Wilson tries to get Cameron to believe Cuddy is going to fire him for sabotaging Foreman’s interview but she sees right through his weak attempt. Wilson becomes annoyed, noting that she would have fallen for this three years ago. Cameron asks whether he thinks she was the culprit, but she denies it. Cameron finds Chase in the lab and asks if he did it because he wanted to sabotage Foreman. Chase is stunned that she would consider him to be that petty.
The genetic lab tests show that Nate has a partial HPRT enzyme deficiency, which means he could have Kelley-Seegmiller syndrome. Yet since it’s partial, he might not have it. Cameron argues that patients with this syndrome self-mutilate, and Nate hasn’t been chewing his lips or banging his head. Chase points out that self-mutilation only happens when the patient is stressed. House wants to stress Nate to the breaking point in order to receive their confirmation.
House walks into Nate’s room with a chessboard and immediately starts mocking him for not wanting to play. This gets Nate riled up. As the game progresses, Nate is surprised that House is a good match for him. House begins taunting Nate, pointing out that nobody likes him. House tells Nate that he’s dying and then takes the boy’s knight with his queen, which puts Nate in check. Nate’s breathing quickens, but then he moves his bishop and smiles. He asks House if he wants to lay down his king, explaining the next four moves that will put House in checkmate. Looking at the board, House realizes that Nate is right. Yet the greater surprise is that Nate is starting to convulse with a seizure.
The next day, House is studying a chessboard and announces to the team that he hates Nate. The team despairs, realizing that they have one more symptom and one less explanation. Chase asks if Nate took any medication and lied about it. This sparks an idea in House. He crosses personality disorder off of the whiteboard and declares that now they are dealing with a normal jerk who suffers from amyloidosis. House tells the team to flush Nate with immunosuppressants, perform a biopsy to confirm and find a bone marrow donor.
The biopsy, however, comes back clean with no signs of amyloidosis. Yet House isn’t deterred, and tells Foreman to biopsy the sinuses for a different reading. Foreman resists, but House says that he can either argue about it and then do it or just do it. Foreman shrugs and walks away. House shouts after him that he wasn’t finished. The third option was to not do what House asked. He could have stuck Nate on antibiotics but he didn’t because he still trusts House’s judgment more than his own.
Chase finds House in his office that night. He knows House was the one who sank Foreman’s interview. Everybody has been chasing ghosts over this, so either nobody did it or somebody wants everybody chasing ghosts. He thinks this sounds like House’s doing. House smiles, admitting that sometimes he forgets why he hired Chase. If House wants Foreman to stay, Chase advises him to just simply tell him. At least it will make Foreman see that House isn’t evil. This idea gives House an epiphany about Nate’s case. When they crossed off personality disorder, they forgot to add another symptom.
House strolls into Nate’s room holding two chess pieces and asks if he wants white or black. Nate grabs for a piece and House notices that he keeps his thumb straight when grabbing objects. House bends the thumb backwards and Nate yelps in pain. He cannot bend his thumb because the bones have formed abnormally due to the junk that has pushed its way between them.
Nate has hemochromatosis, and his body is absorbing iron from his food but he can’t process it. The iron is building up in the organs and joints, creating havoc. As for the personality disorder, House points out that Nate is simply a jerk and that this has nothing to do with the iron. House pulls out the IVs and pokes Nate’s wrist with a scalpel. He calls in a nurse, instructing her to stop the bleeding when three pints have dripped into the garbage can. Nate will need dialysis and a blood drain about every three months for the rest of his life. Other that that, he will be fine.
House finds Foreman in the lab and asks whether he is still running the biopsy for amyloidosis. House has Foreman run it again to recheck his results, and warns him that he will probably have an all-nighter in front of him.

House, MD Season 3 Episode 322: Resignation

A young woman named Addie becomes dizzy in her karate class. She begins coughing up blood. Later, at the hospital, the team reviews the case. Cameron postulates drugs, toxins or infection. She figures that if Addie coughed up blood, then it came from the lungs. However, Addie has no fever or elevated white count, which rules out infection. A blood panel was negative for toxins and her bronchoscopy showed pristine lungs. Cameron then assumes it must have come from the girl's stomach, indicating an ulcer or GI bleed. Yet the ER also did an upper and lower GI. There's no occult blood in the stool, meaning no ulcer or GI blood. Basically, the blood didn't come from anywhere.
House enters asks the team if they've figured out yet that the blood came from nowhere. Cuddy pulls House and Foreman out into the hallway to inquire about Foreman's resignation. He's sure that he still wants to quit. Cuddy has him sign a form to make it official. House wonders why Cuddy isn't begging him to stay. She thinks it wouldn't make a difference. Back in the office, Foreman breaks the news to Chase and Cameron.
Resuming Addie's case, Chase mentions the possibility that a hyperdynamic heart could have forced too much blood into the lungs. It wouldn't leave a trace because the blood came from the veins. House orders Foreman to run an echo stress test on Addie. He sends Cameron to check out the girl's dorm before re-running the ER labs.
While performing the echo stress, Chase asks Foreman why he's leaving but Foreman doesn't give up anything. Chase wonders if that means Foreman is embarrassed about the reason. Addie's heart rate spikes to 170 and Chase can only see goose bumps on her arm. House still thinks it's an infection. He instructs Foreman to start treatment and get a lung biopsy. When Foreman leaves, Chase asks House why Foreman has resigned. House answers that Foreman has decided to raise llamas. Chase realizes that House is also ashamed of the real answer.
House tells Wilson that Foreman is leaving because he doesn't want to turn into another House. Wilson yawns, which House finds intriguing, and then suggests he try to bargain with Foreman. Maybe he can offer him a raise.
As the doctors discuss Addie's case, House asks them what pandiculation is symptomatic of. He is pretending this is in reference to Addie when really it's to learn about Wilson. House then makes a lame joke that Foreman chuckles at. Chase stops short, accusing Foreman of doubting his decision. He's never laughed at one of House's jokes before, but did now because he's nervous. House begins to realize that he was wrong about the infection. He tells the team to attend to Addie before she crashes. They rush in with the crash cart to find her gasping for air. The doctors slide a laryngoscope down her throat.
Chase later explains to the group that Addie couldn't breathe because she had a pleural effusion, which indicates either cirrhosis or heart failure. However, her heart is fine and the liver enzymes are normal. House keys in on the fact that there was blood in the pleural effusion. This confirms his supposition about infection, but Chase argues that it was only minute traces of blood in an otherwise clear liquid. House orders them to double the dosage of antibiotics and check the lungs with an arteriogram.
The arteriogram test comes back normal. House is still convinced it's an infection. The team is skeptical that Addie would keep fighting off an infection that returns, but House wonders if maybe she's missing a protein that cannot be tested. Picking up on his lead, Chase blurts out the disorder of complement factor H deficiency. That would mean Addie is as good as dead. Her body cannot fight off bacteria, and she will succumb to one infection after another until her body shuts down. Since there's no diagnostic test for complement factor H deficiency, House wants them to isolate the cells that are most attractive to that affliction. They need to stick a needle in her eye.
Despite the case, House is still subject to clinic duty. He treats a man named Steve who complains of floating stool. Accompanying Steve is his girlfriend, a free-spirited nutritionist named Honey. She is disappointed because Steve has been cheating on her by eating meat. House sees this as an opening to ask Honey out. She accepts.
House crushes up some amphetamine pills and secretly drops them into a cup of coffee for Wilson. Wilson is naturally suspicious of House being nice. So he grabs the cup that House isn't offering, but that is the one filled with the amphetamine.
Addie's macular biopsy comes back negative, proving that it is not complement factor H deficiency. House still thinks it's an infection. They take a brain MRI, and Addie cries out during the procedure that her head hurts. When the doctors pull her out from the machine, they are shocked to see that the top of Addie's head has somehow burst open, leaving blood and tissue oozing onto the table.
The doctors anesthetize Addie and begin debriding the tissue. Foreman notes massive tissue death and Cameron notes that it doesn't have any pus, which should rule out infection. House again refuses to back off his diagnosis. Chase thinks it's more likely to be autoimmune, which means they need to start steroid treatment immediately. House invites him to proceed as long as Cameron stands by with the crash cart. If Chase is wrong, Addie's heart will give up almost as soon as they start with the steroids.
House stands by in the hallway as Chase starts the steroid drip, eagerly anticipating the massive heart attack. Yet nothing happens. Cameron smiles and turns the crash cart off. House is somewhat annoyed.
Wilson calls Foreman to his office. Foreman immediately notices that Wilson is going a hundred miles an hour. Wilson blurts out that House wants Foreman to stay. Before he leaves, Foreman says that he knows House is a good doctor.
Wilson tracks down House at home and angrily accuses him of drugging the coffee. When Wilson yawns, House is positive that the yawning is a symptom of something else. He posits that Wilson is taking anti-depressants. House says he would be on them as well if he wasn't in denial about his depression.
That night, Cameron wakes House up because he wasn't answering the phone. She informs him that Chase was wrong. Addie's kidneys have shut down. House actually smiles at the news.
At the hospital, Cameron announces that hemolytic uremic syndrome is what caused Addie's kidneys to shut down. House remarks that this is usually caused by an infection or a protein deficiency. House gloats that he was able to diagnose an invisible disease based on coughed up blood. The team is more interested is what they're going to do next. If House is right, the steroid treatment means that Addie's next infection will be ferocious. So they decide to wait for a stroke or heart attack to confirm an infection.
Eventually, Addie suffers a heart attack. The doctors are barely able to save her. Foreman gives the news to House then asks if he even knows the patient's name. House doesn't, but he argues that this is not what is important to him or the family. House thinks Foreman doesn't want to quit. Foreman asks if that statement actually means House doesn't want him to quit. House scoffs that Foreman is under the impression he can make House a gentler person. Foreman cuts him off, charging that House is about to tell a young girl she's dying but all he can think about is himself. Foreman hopes to God he's not like House.
House walks into Addie's room, apologizes and then tells her she's dying. The infections will continue to get worse. She has two days or less to live. House attempts to explain the disease, but she doesn't want to hear it. House is amazed that Addie doesn't want to know what's killing her. She questions whether knowing will make her live longer. House wonders what life is without curiosity. As he talks about diagnosing problems, Addie notices that he is smiling. He catches a reflection of himself and she's right. House is actually smiling as he talks about this in front of a dying girl. He abruptly exits.
House barges into Wilson's office and blames him for dosing House with anti-depressants. Wilson smiles, unable to hide the truth. They've obviously worked. A miserable girl just noticed how happy he was. House counters that she wasn't miserable and has been in that same mood all along. House freezes with an epiphany.
House barges into Addie's room and orders her parents out. He sits down and tells Addie that depression manifests itself in many different ways. She tried to kill herself by downing kitchen cleanser. Since she is intelligent, she knew that it would sting her mouth and throat. So she must have wrapped the cleanser in a gel cap, which burned a hole in her intestine yet left no other trace behind. Scar tissue fixed the hole but also formed a bridge between a vein and an artery. Instead of her veins sending bacteria into her fecal matter where they should be eliminated, the bacteria was being sent back into her system. Yet does Addie want them to fix her? Surgery will only take two hours but the psychotherapy will take longer. Addie cries, confessing that she's never been happy. She begs House not to tell her parents because they will blame themselves.
As surgeons work on Addie, Cuddy tells Foreman that House isn't actually that bad. She questions whether he really is afraid of turning into House. Foreman says it's not worth it and leaves.
That night, House meets Honey at a bar. He orders the same peppermint tea that she's drinking. Honey is under the impression that House is interested in hiring her as a nutritionist for his team, but House has another, more personal, relationship in mind. He points out that he hates tea. Then he lists all of his many shortcomings. Honey is not put off by any of it.

House, MD Season 3 Episode 321: Family

A 10-year old boy named Matty puts on a sterile hospital gown and latex gloves. His mother Claudia does the same. She prepares Matty to see his older brother, Nick, who just went through an extra course of chemo and radiation for leukemia. When he enters the isolation room, Matty is frozen by the sight of his bald brother. Wilson takes Matty off for his own procedure -- a bone marrow donation. As Wilson discusses the importance of the surgery, Matty sneezes. Wilson can’t do a transplant until he knows what’s wrong with Matty.
The team gathers to discuss the case. Matty has an enlarged spleen and fever. Even if this was just a basic cold, a bone marrow transplant right now would kill Nick. Since the family is black, it is almost impossible to find another donor. House suggests making Matty sicker in order to induce the infection the become more prevalent and easier to spot. Foreman disagrees, figuring they should check the family home for environmental causes.
Foreman and Chase inspect the home. Still shaken by the death of his last patient, Foreman asks Chase for advice on how to move forward after botching a diagnosis. Chase replies that time eventually allows you to stop thinking about it on a daily basis. Foreman argues that Chase was distracted by the death of his father when he accidentally killed a patient, whereas Foreman made a calculated decision. Chase sees a rusted water pump in the backyard and he takes a water sample. Perhaps Matty took a drink one day after playing baseball in the backyard?
Back at the hospital, the doctors question Matty about the fountain. He did drink from it once last summer, but the water was disgusting and he never tasted it again. Matty also suffers from an acute scrotum. House sees this as a positive sign because only a few infections cause swollen testicles. He orders urinalysis and cultures for E. Coli, klebsiella, TB and brucellosis. He also wants blood tests for enteroviruses and adenobviruses.
The tests all come back negative, so Chase begins to wonder if they’re on the wrong track. In their quest to make Matty sicker, they might have inadvertently helped the infection spread to his heart. Chase and Cameron perform a transesophogeal echo on Matty and find a growth on the mitral valve. It will require at least a month’s worth of antibiotics to clear that up. However, Nick only has about four days to live.
House suggests removing the valve, but Chase doesn’t think the infection will clear the boy’s system in time. Foreman believes that Matty will be fine with antibiotics and doesn’t need open heart surgery. House shifts gears, and decides they can perform the valve surgery. Then they will harvest Matty’s marrow, stew it in the targeted antibiotic and replace it. Concerned about this wild plan, Foreman announces that he’s going to run it by Cuddy.
After hearing the various arguments, Cuddy orders Wilson to simply explain the choices to the parents. She asks House why he let Foreman go far with his caution. House explains that he thought it would be good for Foreman since he seems to now be frozen in his decision making. He has the yips, much like how a great athlete might suddenly lose his determination. Of course, House only plans on giving Foreman four days before he fires him because one doesn’t recover from the yips.
Wilson breaks it down for the family. This procedure should work, but due to the valve replacement, Matty would have to be on blood thinners to prevent clots for the rest of his life. It would prevent him from playing baseball due to the risk of hemorrhage. Wilson advises them to protect the family as a whole and opt for surgery. They consent and the surgery is begun.
That night, Wilson wakes up House. They biopsied a piece of the valve before removal. It was fibrous tissue and not infectious. Now they have to figure out what is turning Matty’s healthy heart tissue into gristle. Cameron thinks it could be autoimmune, so House sends them off to figure out which one.
All tests for autoimmunity are negative. What’s worse is that Nick is starting to deteriorate. His capillaries are leaking blood. If that moves to the brain, he’s dead. Cameron suggests going with the 4 out of 6 level marrow match Foreman found in the registry. House rejects that because he wants a 6 out of 6 level match.
Foreman, however, informs the family about the 4 out of 6 match which gives Nick a chance. The parents are greatly encouraged. House and Wilson later try to talk them out of it, but it’s no use because they have made up their mind. Outside, House berates Wilson for not having the courage to manipulate the parents into what the doctors feel is the right decision. At least Foreman was doing what he thinks is right.
The transplant is started on Nick. Foreman hooks up antibiotic IVs to Matty. Later, Cameron checks up on Matty, who complains of an itch. She sees blood dripping from his ear and calls House with the news. Matty’s not making new blood cells and his bone marrow is crashing. House thinks they need to stop Matty’s meds. If he recovers, then the meds were the problem. If not, it’s the infection. Matty is in worse shape than they thought.
House and Wilson return to the hospital and promptly learn that Nick is suffering from a grade four Graft vs. Host issue. The new marrow is killing him. House asks Foreman if he’s feeling guilty, but Foreman is adamant that he did the right thing.
Matty isn’t improving, meaning that the infection is to blame. House has an epiphany. If blood cells won’t grow in Matty because he’s too weak, they should put Matty’s blood in Nick and see what happens. Maybe that will lead them to the infection in question. Since Nick is going to die anyway, they can use his body as a Petri dish to quickly tell them what the issue is. The doctors don’t see any other way.
Wilson presents this situation to the family. At first, they refuse to accept that Nick is as good as dead, but House makes it clear that there’s no coming back for him. The only question, as House sees it, is whether they leave the hospital with one dead son or two. With House’s prompting, Wilson encourages the parents to consent. Yet they say no. They’re not giving up on Nick.
House is stumped. Foreman is ready to start testing Matty to learn what infection he has. House scoffs that with 10,000 possible infections and 20 minutes per test, it’ll take Foreman about eight years to pinpoint the cause. Foreman counters that it will actually be four months. Unless, of course, they get lucky and Foreman is right with the first test.
Nick writhes in agony. House writes out a new prescription and gives it to Nick’s father, who runs off to get it filled. House intentionally wanted to be alone with Nick. He explains that he is dying, but Nick already knows that. House says that his life doesn’t have to be meaningless. He could save Matty.
Meanwhile, Wilson and Foreman churn through tests. Wilson tells Foreman that House is going to fire him because he feels he’s gotten timid. Foreman couldn’t care less about that right now. He would rather focus on waterborne infections since Matty drank from the old pump. Wilson wonders why a cookie cutter house in the suburbs has an old fashioned hand pump in the yard. Foreman realizes that this is rather odd.
Nick talks with his parents, trying to persuade them to let him go in order to help Matty. He wants to do it for them so that they won’t be alone. The parents break down and consent. Before they can wheel Nick away for the procedure, Foreman bursts in with the news that they figured out what’s infecting Matty. He’s got a fungal infection called histoplasmosis. It’s found in chicken feces. The subdivision was built on top of old farmland, and the pitcher’s mound that Matty built in the backyard must have sat under a chicken coop back then. Matty inhaled some dust and got infected. The bad news is that Matty doesn’t have enough marrow left for a transplant, even with treatment for the infection.
Foreman inserts a new IV into Matty and then makes a bold move. He can access marrow from Matty’s hip bone. Doctors don’t do that normally because it’s painful and dangerous to access. He can’t sedate Matty due to the infection and the boy will only have a little marrow left after this. Yet Foreman proceeds anyway. He straps Matty to the gurney and plunges a long needle into his hip. The boy shrieks in pain and begs him to stop. Foreman presses on.
His risk proves to be a success. Nick gets his transplant. The parents are mad, but the end result quells that anger.
House has a conversation with Foreman to see how he’s handling all of this drama. Foreman is angst-ridden that he could listen to Matty screaming in pain and never question whether he was doing the right thing. He hates the idea that, in order to be like House as a doctor, he needs to be like him as a person. Foreman gives House his two weeks notice that he is quitting.

House, MD Season 3 Episode 320: House Training

While a hustler is running a three-card monte game, his shill Lupe, gets confused and blows the game for him. Lupe collapses to the ground. Much later, Lupe explains to Foreman that she felt like she couldn't move inside her head. Foreman says she had an abulia, or the inability to make a decision or exercise will. This is part of a bigger issue called Transient Ischemic Attack. The blood was cut off to a section of Lupe's frontal lobe. She claims she has no drug use, so toxins might be another explanation.
The team argues about possible causes, but Foreman is adamant that Lupe is a drug-abusing scam artist. Chase thinks it is toxins. Yet her tox screen comes out clean. House is more interested in why Wilson was talking to his second ex-wife. Wilson says that she merely asked him to start looking after their dog. House then confesses that he asked Cuddy out to a play. He was only testing her. She said she was busy, but then why did she say yes to Wilson earlier?
Foreman's dad, Rodney, waits in the hospital for his son. He wants Foreman to come to his mother's upcoming 60th birthday party. She should see him while she still knows who he is.
Chase and Foreman go to Lupe's apartment for an environmental check. Chase finds a number of possible toxic causes in the apartment, but Foreman sees a crack pipe, which seemingly gives him the stronger argument. Chase says he will do the tests on the pipe so that Foreman can visit his family, something he doesn't really want to do.
Foreman tracks down his family at a nearby hotel and his mother is thrilled to see him. As she talks to him about the past, symptoms of her Alzheimer's come rushing to the fore.
Later, Foreman confronts Lupe about the pipe but she denies that it's hers. He advises her to warn whomever it belongs to that they have arsenic poisoning. Lupe starts hacking with a cough and then spits up blood on Foreman's jacket. She begins choking on the blood that's filling her throat.
Chase and Cameron run a CT scan on Lupe after a hair test only shows trace amounts of arsenic in her system. The scan reveals a mass just outside the lingual. A biopsy later shows white blood cells in the walls of the blood vessels, which isn't normal. Figuring this has to be some sort of autoimmune issue, Foreman is ready to start a treatment of steroids. House wants to know exactly what autoimmune disease it is. In the meantime, they are to begin the steroids.
Foreman checks up on Lupe, dismissing her explanations about a one-time drug use. She realizes he doesn't like her, then accuses him of being like someone who quit drinking or lost a lot of weight and looks down on those who can't. Just because he got out of the projects, he thinks anybody who hasn't is weak and stupid. Throughout this speech, Lupe struggles with a cough. Foreman studies her eyes, noticing yellow in the sclera.
Foreman reports back to the team that Lupe's liver is failing. It's not an autoimmune disease. He suspects lymphomatoid granulomatosis, which is incredibly rare even by their standards. He suggests that they start total body radiation immediately to fight the rapid spread of the cancer. House instructs Foreman to get her consent in order to begin the process. Foreman explains that Lupe doesn't like him so much. House jumps up to get the consent. If she doesn't like Foreman then he is dying to know why.
When House asks about Foreman, Lupe complains that he thinks he is better than he is. After explaining the myriad possible side effects, House hands Lupe the consent form. She freezes, and falls under another attack. House calls in the nurses, instructing them to have Lupe sign the consent form when she comes out of the attack.
Cameron and Foreman check up on Lupe after the radiology. Foreman detects a heart murmur, which is a bad sign. Cameron tightens the cuff on Lupe's arm to check her blood pressure and Lupe begins screaming in agony. After receiving news of this latest development, House realizes just how much trouble they're in.
Foreman asks Wilson for advice on how to break a terminal diagnosis to patient. Wilson tells him to be honest and to be there when the patient needs support. Foreman slides in Lupe's room and flatly informs her that she's dying. He estimates less than 24 hours to live. She came into a hospital with an infection and they didn't catch it. The radiation is the worst thing they could've possibly done because it destroyed her immune system, allowing the infection to spread to her heart. Now, there's nothing that can be done. Lupe angrily tells him to get out.
Foreman tracks down House in the ICU and declares that he is wasting their time and causing Lupe more pain. House counters that he needs to know what they missed. They have Lupe wheeled back into a private room. Foreman apologizes to her, but admits that he doesn't expect her forgiveness. When he learns that she has no close family or friends, he sits down to spend the night in her room.
When Lupe wakes up the next morning, Foreman confesses that she was right. He did have a problem with her at first. But she was also wrong. He explains that he had a rough past but received another chance. He still feels like someone will send him back from where he came if he's not always the smartest person in the room. He put distance between himself and Lupe only because he knows there isn't any.
With Foreman still at her bedside, Lupe falls into a coma and her vitals flat line. Foreman calmly switches off the monitoring equipment and notes the time. He calls in the time of death to House, who readies himself for an autopsy. Wilson later finds House in Lupe's room. House explains that Lupe scratched herself with her bra hook and developed a staph infection.
House finds Foreman in his office and tells him to absolve himself for Lupe's death. He should only try to improve himself. Foreman is torn up that they blew such a simple diagnosis, but House consoles him that he'll do it again. This is a good thing. They are a special band of doctors practicing a special kind of medicine. They will miss on a few patients, but they will also save the ones any other doctor would think are hopeless causes.
That night, Foreman goes to his parents' hotel and tells his mother that he hurt somebody. She throws her arms around him and forgives him. She can see that he'd never hurt anybody on purpose. Foreman asks his mom if he knows who he is. She hugs him again and says that her little boy's name is Eric. Foreman is devastated.

House, MD Season 3 Episode 319: Act Your Age

An 8-year old boy named Jasper gets a bloody nose at day care. His father Deran arrives and learns that Jasper was involved in a fight. The teacher seems concerned about the blood that has been flowing for ten minutes, but Deran remarks that this isn’t Jasper first nosebleed. Deran then turns to see his daughter Lucy on the floor of the day care. She is gasping for breath.
Later, Cuddy presents House with Lucy’s file and declares constrictive pericaditis, an affliction usually found in much older people. The girl is in surgery. House throws the file at his team, tells them to check for sarcoidosis, amyloidosis and hemochromatosis. He then leaves for the night.
Having stayed up all night, Foreman and Cameron inform House that all of the tests were negative. Chase went home for a full night’s sleep because he figured the tests would be negative. He comes in that morning with the pathology report. They found granulomas in Lucy’s pericardium, which indicates a fungal infection. House orders Cameron and Chase to biopsy a lymph node. They must do it together.
Chase and Cameron begin the biopsy. During the procedure, Deran reveals that their mother died last year of brain cancer. Jasper begins flirting with Cameron. Lucy asks for her bunny, but when Cameron tries to hand it to her, she just flails at it. Lucy says she didn’t know which bunny to grab.
Cameron tells House that the girl’s double vision led them to a slit lamp test, which showed that the eye’s anterior chamber is swollen. This is a sign of uveitis. Chase announces that the lymph node biopsy was clean. Foreman declares that vision issues plus heart troubles most likely equal autoimmune disease. House asks if Lucy’s knees are scraped up. Most 6-year olds like to play outside, but Lucy doesn’t. Is that because running around hurts Lucy’s joints?
Foreman informs Deran that the doctors suspect Juvenile Rheumatoid Arthritis. Fortunately, they caught it early, which gives the best chance for a good outcome. Lucy then sits up in bed. Her left eyelid and left side of her mouth droop. Foreman recognizes a stroke.
The stroke was caused by a blood clot in the middle cerebral artery. Cameron brings up polycythemia, or thick blood. House realizes that thick blood would possibly explain the stroke and the autoimmune response. A lack of oxygen would cause overproduction of red blood cells, which thickens the blood. House tells Chase and Cameron to check out the family home for possible environmental causes. Cameron snaps about being punished by forcing them to work together. House says he’ll be happy to fire one of them if they can’t get along.
As Chase and Cameron head out, Jasper runs up with a bouquet of flowers for Cameron. He stole the flowers from a family with a newborn. Cameron takes one flower and kisses Jasper on the cheek before sending him back. Elsewhere, Foreman drains blood from Lucy to help the flow and reduce the chances of another stroke.
Inspecting the home, Chase finds multiple letters from school about Jasper getting in fights. Searching Lucy’s bedroom directly above the garage, Cameron finds a vent under the bed. She and Chase check inside and find a child’s t-shirt stained with blood.
Cameron tells the team that she suspects Deran is abusing Lucy. House is upset mainly because they need to spend a day figuring out if this is abuse or a relevant symptom to Lucy’s case. Foreman bluntly asks Deran if he’s abusing his daughter, showing him the t-shirt. Deran angrily denies it, but Foreman gives him two choices. He can either consent to the exam or the hospital will call social services, who will force him to consent.
Cameron performs a full physical check on Lucy, including a vaginal exam. To her shock, Cameron finds cuts all over Lucy’s genital area. They are almost like slices. Some are almost healed but some are fresh. However, the cuts are not deep enough to account for all of the blood on the t-shirt. There also isn’t any vaginal tearing. Foreman wonders if the blood on the shirt isn’t Lucy’s.
Lucy’s blood is tested and contained endometrial cells. Another test showed that it was definitely her blood on the shirt. Six-year old Lucy had menstrual blood and has started puberty. Cameron explains the diagnosis to a stunned Deran. Excess sex hormones can confuse a body, leading it to blossom prematurely.
The team figures that a pituitary adenoma is spiking Lucy’s hormone level. House instructs them to look for a tumor in her brain. If it’s not there, it’s probably in the reproductive tract. They are to start from the top and work down. Cameron, arguing that it could be hormonal additives in the chicken fingers and milk Lucy lives on, is going to check for estrogen. The MRI reveals a solid tumor on Lucy’s left ovary.
A worried Wilson catches up with House. He took Cuddy to a play that House gave him two tickets for. Now Cuddy has sent Wilson thank you flowers with a card saying they should do it again soon. Wilson is panicking that House was right. Men and women can’t be friends and nobody goes to a play platonically. After Wilson runs off, House smiles at Cuddy and tells her he sent Wilson some flowers.
Jasper finds Cameron in the hallways and asks if Chase is her boyfriend. If he isn’t, then Jasper wants to be. Cameron walks him back to his father and he grabs her rear.
Foreman and Chase perform a laproscopic biopsy on Lucy when she crashes. Foreman has to shock her back to life. The biopsy shows that the supposed tumor is actually a benign cyst. Cameron gloats that her suspicion of hormones in Lucy’s environment must be the right direction.
Late that night, Chase and Cameron are grabbing some coffee when he says she must have feelings for him. He tenderly grabs her arm. Suddenly, Jasper comes running in screaming that he’ll kill Chase if he touches Cameron. He bites Chase. The doctors call House to tell him what happened. House realizes that Jasper is out of control aggressive, and the cause is probably extra hormones. Whatever Lucy has, Jasper has it too.
A test shows that Jasper has 100 times the testosterone of a normal 8-year old. The team hasn’t found any hormone-secreting tumors in his body. Chase raises the issues of genetics. A brain tumor killed the mother, so perhaps the kids have one too. As Foreman performs a bleed on Jasper, Lucy begins crying out that her stomach hurts. A new MRI reveals a cyst in Lucy’s pancreas, two more in her kidneys and one in her lungs. They weren’t present 48 hours ago.
Chase learns that the mother was perfectly healthy until she got cancer. Genetic causes are thrown out. Environmental causes have already been thrown out. Cameron insists that it has to be a pituitary adenoma, even though a scan has yet to reveal one. They should remove the pituitary gland. House says no, but Cameron argues that this is exactly how he does things. They’ve eliminated every other answer. Brain surgery is all that’s left.
Cameron presents Deran with the options, pressing for surgery. House appears and attempts to submarine Cameron’s efforts, arguing that they don’t really know what’s happening yet. Cameron presses about environmental causes, but the only possible option is that they both attend the same daycare. However, Deran points out that none of the other children are sick. He signs the consent form. House asks the man how he knows the other children are healthy if he’s been in the hospital for the past four days.
House visits the daycare and accuses the supervisor, Janie, of dating Deran. She admits that she is, but stresses that she’s never been to the home. House stares at her, noticing a red rash on her upper lip. She confesses to having a mustache wax over lunch. House calls the hospital and tells them the cause is Deran.
House returns to the hospital to confront Deran, who says Janie is so much younger than him and he has trouble keeping up. He’s been using a male enhancement cream, which House points out is loaded with testosterone. Every time he hugged the kids, they received some of the testosterone Deran was excreting through his skin. If he stops using the cream, Lucy and Jasper will be fine.
That night, Wilson comes into House’s office, still in angst over the flowers. Wilson wonders if this is worth exploring. He decides to march down to Cuddy’s office and, without a word, kiss her. House encourages the bold move. Wilson leaves, and after a moment, bursts back into House’s office, enraged that he was going to let him go through with that. He knows House sent the flowers.
House and Cuddy watch as Deran leads Lucy and Jasper out of the hospital. Cuddy laments the freakish nature of the kids’ problem, wondering why it’s so hard for people to find a suitable mate. House looks at her and then mentions that he has two tickets to a play.

House, MD Season 3 Episode 318: Airborne

Fran is a seemingly conservative, middle-aged woman. She collects porcelain figurines and wears a cable-knit sweater. Fran welcomes a woman named Robin into her home. Robin is a prostitute. When Fran sees the woman’s revealing outfit, she becomes dizzy and faints. Robin calls an ambulance.
As Robin stands nearby, Wilson examines Fran. He finds a motion sickness patch on her neck. Fran assumes that she forgot to take it off after a trip to see her sister in Duluth. Wilson informs her that scopolamine can cause dizziness and blurred vision, and the blackout most likely occurred when she conked her head on the floor. As she is being discharged, Fran falls to the floor in a seizure.
After she is readmitted, Wilson notices a fresh tattoo on Fran’s leg. He questions whether she really went to Duluth. Fran confesses that, when she recently turned the same age her mother died at, she decided on a whim to visit Caracas. While there, she got a tattoo, drank, partied and had sex with a stranger.
Wilson presents Chase, Cameron and Foreman with Fran’s new case study and a litany of potential diseases. Wilson orders them to get a tox screen, chem 20, STD panel, blood cultures, a CT scan and to also check Fran’s house for possible environmental causes.
Meanwhile, House is wheeled onto an airplane in Singapore with Cuddy. His vinter’s cane -- which hides a corkscrew -- was confiscated by security. Cuddy laments the incredible room charges House accumulated in a Singapore hotel. He defends himself by explaining that she shouldn’t have dragged him across the globe simply for a three-minute speech, even though it acquired Princeton-Plainsboro WHO accreditation.
On the flight, the man across from House seems ill. The man named Peng groans and then vomits on his food. Keo, the flight attendant, asks if anybody speaks Korean or is a doctor. House gets up, and then walks to the back of the plane to get Cuddy.
Cuddy is worried that Peng is suffering from meningococcus. The whole plane could end up infected and she thinks they need to turn around immediately. House, having noticed Peng’s medic alert bracelet, passes it off as a mere allergic reaction. Moments later, another passenger named Joy starts to vomit. House figures it was just the smell of Peng’s vomit that made her sick. Yet when he lifts up Joy’s shirt, he sees that her back is covered with the same nasty rash that plagued Peng. House becomes officially concerned.
House heads to the front of the cabin and begins writing various symptoms on the movie screen as if it was his white board. Cuddy informs House that the plane has passed the halfway mark, and they are now at least six hours from landing. House asks Keo about the dinner menu. Peng had eaten sea bass and Joy had seafood kabobs, which contained sea bass. House declares that they are suffering from ciguatera poisoning, which is an instant-onset toxin claiming all of the symptoms House scribbled on the board. House gets on the PA system and asks everybody who had the sea bass to go into the bathrooms and vomit as soon as possible because it should keep the effects of the toxin to a minimum. Cuddy then whispers to House that meningococcus still makes just as much sense. House admits that she’s right.
Peng’s health worsens. If they soon start seeing neurological symptoms, they will all be in trouble. Testing for ataxia, House indicates to Peng that he should stand up and walk toward him. Peng’s legs lock and he falls to the ground.
House examines Peng’s leg and sees that it’s thin, probably from a recent break. He declares that Peng has radiation poisoning from the x-rays. He tells Joy that she’s pregnant. All of the symptoms fit both diagnoses. Suddenly, Cuddy doubles over and vomits. House finds a fierce rash on her back as well. She didn’t even have the fish.
Back in Princeton, the team comes up with negative results for all of Fran’s tests. However, her seizures have slowed since the doctors put a motion sickness patch back on. They were concerned the scopolamine was controlling her symptoms. Wilson realizes that she is suffering from breast cancer. Since she was on vacation, he assumed that Fran had an exotic problem. But the inflammation triggered by the paraneoplastic syndrome caused by cancer can be reduced by the anticholinergics found in motion sickness patches.
Cameron performs a mammogram on Fran when she begins blinking. She can’t see out of her right eye. The doctors perform a Visual Evoked Response test with a dozen electrical anodes attached to Fran’s forehead. Various patterns shine on a screen in front of her.
In the skies at the same time, House shines a flashlight in Cuddy’s face. Agitated, she waves the light away, then declares she has photophobia, a symptom of meningitis. Keo comes into the cabin with word that three more passengers are sick. House walks through the cabin with a young patient in an attempt to collect any medications that passengers might be carrying.
In the hospital, Foreman and Cameron note a spike on Fran’s EEG in her left eye. She falls into a coma. The team bickers about how to proceed. Foreman insists she has a cranial bleed that the CT missed and that they need to create a burr hole immediately to relieve the pressure. Cameron, doubtful the test would miss it, suggests an LP to confirm the presence of red blood cells. She asks Chase what he thinks and he agrees with her. Foreman rolls his eyes, growing tired of their relationship causing Chase to always agree with Cameron. Wilson decides to play it safe and go with the LP first.
Cameron and Chase prepare Fran for the LP. House is preparing to do the same on Peng, but with much more meager supplies. A syringe with plunger removed, a plastic shot glass and an alcohol swab. The needles are inserted in each patient’s back. House collects the liquid that drains out in a shot glass. Chase does the same, only into a sterile test tube.
House hasn’t found much in his pill collection, but there are three tablets of augmentin. Cuddy wants them given to Peng because he’s in the worst shape, but House reminds her that he’s allergic to penicillin. If he has a reaction, he dies and they’ve wasted the pills. House then realizes that Cuddy is right.
House studies the liquid from Peng’s spinal column and his face drops. Ignoring Cuddy’s frantic pleas to know what it is, House heads to the main cabin and informs the passengers that they have a confirmed case of bacterial meningitis. Peng will not survive and it’s likely that several others have also been infected. Anybody who feels the various symptoms needs to come to the first class cabin for isolation. The passengers start to panic. House warns them that they all don’t actually have meningitis, but are merely suffering from mass hysteria.
He pleads for everybody to calm down so that their imagined symptoms will soon disappear. House returns to the first-class cabin and tells Cuddy that the clear LP fluid confirmed his thoughts. Her rage, a symptom of mass hysteria, gave rise to a new theory. However, Peng is still dying and House has absolutely no idea why.
House scribbles new symptoms down on the movie screen and convenes three passengers to play the roles of Foreman, Chase and Cameron and run through the differential with him. Cuddy mentions syphilis. Thinking of condoms makes House realize Peng has focal limb paralysis. Peng may have swallowed cocaine-filled condoms as a courier, and the drug might be spreading through his digestive tract. They need to operate.
In order to perform surgery on Peng, House asks if any passengers snuck a knife on board. A man reluctantly admits that he has a ceramic knife which wasn’t sensed by the metal detectors. House’s new team helps pin Peng to the floor as he prepares a pair of gloves, three plastic spoons, four alcohol wipes, a small pair of pliers and a sewing kit.
The 12-year old boy assisting House presses down on Peng’s shoulder, which seems to relieve the patient’s pain. Noticing that pressure on Peng’s joints relieves pain, House realizes he’s wrong about the cocaine. They need to find Peng’s wallet.
House uncovers what he’s looking for in the wallet -- a receipt from a scuba rental shop. Peng has the bends. They need the pilot to descend under 5,000 feet as quickly as possible and drop the oxygen masks.
Back in the hospital, Fran is wheeled into surgery with her head shaved. Chase and Cameron watch from another room. He thinks their relationship is actually affecting their work. They even had sex in Fran’s bedroom while checking for environmental causes. Cameron mocks Chase for being worried about Fran’s cat watching them. This triggers a revelation for Chase. Fran hasn’t eaten anything since entering the hospital. He rushes off.
Chase re-inspects Fran’s home. The cat is now dead, although its food bowl is still full. The surgery team prepares to drill into Fran’s head and Foreman peels back a section of her scalp, exposing the skull. In Fran’s driveway, Chase finds a pipe that leads to the house next door. Tacked to the front door of the next house is a notice that the place has been fumigated with methyl bromide. Chase quickly calls the hospital and tells them to stop surgery.
The doctors explain to Fran that fifty years ago, her home was one estate. The two homes shared an electrical system. Unfortunately, the exterminator didn’t realize that. When it was fumigated, the poison gas flowed through the electrical conduit into her home. She will need to stay in the hospital for a few more days, but ultimately she’ll be fine.
The flight finally touches down in New York. Keo slyly lets House know that she is in New York every Monday.
Wilson calls the prostitute Robin to let her know that Fran will be fine. Then he asks if she might be coming back to visit.
As they leave the hospital that night, Chase tells Cameron that he wants their relationship to be a little more normal. He doesn’t want simple sex any more. Cameron reminds him that’s what he signed up for originally. If he’s no longer game, it’s over.

House, MD Season 3 Episode 317: Fetal Position

Famous celebrity photographer Emma Sloan is five months pregnant. She arrives late for a shoot with a band member from All-American Rejects. She complains that the words on the backdrop are jumbled even though they are correct. Emma panics and shouts for somebody to call 911 because she's having a stroke.
House ambles into Emma's hospital room with a quick order to hold her arms out with palms up. Her right arm begins to droop. House asks if her ob gyn cleared her and her fetus. Emma affirms this and House calls him an idiot for missing the pronator drift. House examines Emma's eyes and notices an issue with vessels. He thinks her microaneurysm is a predictor of future strokes. In the conversation, House learns that Emma was artificially inseminated with a donation from a gay neurologist. He also notices that Emma's catheter bag is half-filled with blood.
The team later reports that a urinalysis revealed that there was excessive protein and red blood cells. A chem panel showed a creatinine level over 2.5. After the stroke, Emma's kidneys have been shutting down. Cameron wonders if the kidney problem came first and threw off a clot that caused the stroke. House thinks the heart is much more likely to throw off a clot and mentions the six cases of strep in Emma's history. Untreated strep leads to Rheumatic fever, which leads to mitral valve stenosis, which leads to the team exiting the office to go check Emma's heart.
While Emma lays in a CT scanner, Chase and Cameron discuss House catching them in the supply closet. Chase doesn't think it's a big deal, but Cameron worries that House has some secret plan in the works. Chase wonders if Cameron is simply annoyed that House caught them and doesn't care. He then notices a calcified mitral valve in Emma's heart.
Emma is put in surgery so that Chase and Cameron can insert a balloon into her narrowed valve. They believe this will solve her problems as long as she finishes her prescribed antibiotics the next time she gets strep. But before they start, Cuddy enters. With a smile, she starts giving Cameron and Chase orders on how to approach the procedure they've done numerous times in the past.
The team finds House in his office making vacation plans with a direct flight to Phnom Penh. They tell him about Cuddy, which House brushes off. They go on to explain that Emma's kidneys are still failing. House figures that means they screwed up the procedure, but Cameron counters that maybe House screwed up the diagnosis. Considering the pregnancy, the doctors mention pre-eclampsia, proteinuria, low platelets. They also bring up hypoperfusion, a condition in which a fetus acts like a parasite and steals crucial nutrients and blood from the mother. Foreman, mentioning the pregnancy could be irrelevant, wonders about sepsis or HUS/TTP. House sends them off to check for everything.
All of Emma's tests come back clean. The doctors are baffled. Everything that screws with the kidneys is something they considered. House approaches Emma and informs her that they've eliminated all possibilities for her body. But the other body -- the fetus -- isn't performing so well.
House convenes his team in the office and explains Maternal Mirror Syndrome to them. In short, the creation of a new system inside a functioning body goes wrong. As the fetus slowly dies, rather than miscarry or become a stillbirth, it kills the mother's body as well. The good news is if they fix the fetus, Emma will get better. The bad news is that this syndrome rarely turns out favorably. House suggests they start with a look at the fetus's heart. Unfortunately, it's nearly impossible to get an accurate scan on a fetal heart because the fetus doesn't stop moving. Yet House has a solution. He's going to paralyze the fetus.
Cuddy catches wind of this scheme and tries to stop House. House is quickly able to talk her into it. And together, they're able to talk Emma into the procedure. Everything is a success and the fetal heart is structurally sound according to the MRI. However, the bladder is four times the normal size. It's so engorged that it's squeezing out the other organs, not allowing space for the lungs to develop. Cuddy informs Cameron that it's a lower urinary tract obstruction that can be fixed by inserting a shunt. Cameron asks if Cuddy is taking over this case, and Cuddy replies that House won't care now that the diagnosis is in. Cuddy then warns Cameron that dating Chase can only end in one of two ways: marriage and happiness, or a breakup that leads to Cuddy having to fire one of them because they can no longer work together. Cameron knows that House told Cuddy about them.
Cuddy informs Emma of their plan to insert the shunt, which should solve the problems. They will have to check the fetal kidneys first to make sure they function properly. If they're too damaged, there's nothing the doctors can do.
Cuddy finds House in her office. He happily explains to her that her kidney test will be inconclusive. The urine is stale, and she'll need to do at least three kidney taps before she can find fresh urine. Then he asks Cuddy why she's so interested in this case. Perhaps Emma is basically Cuddy, a single woman in her 40s who is using in vitro. He wonders whether Cuddy wants Emma to succeed to give herself some hope. Cuddy thinks on this, and agrees. She gives the case back to House.
Chase breaks the news to Emma that the fetus's kidneys aren't damaged. They're going to insert the shunt and everything should turn around. Surgery for the shunt is a success and the fetal bladder starts to decompress. Emma complains of abdominal pain and when Cameron checks her eyes, they're yellow. Cameron and Chase let House know that Emma's liver is now failing. House begins to wonder what the fetus is hiding. Maternal Mirror Syndrome has one surefire cure: delivery. However, a fetus isn't viable at 21 weeks. Who gets to tell Emma?
Emma asks about putting the fetus on ventilators, but the fetus is at least two weeks away from being viable. The catch is, her liver isn't going to last two more days. Emma refuses an abortion, so House points out that either the fetus dies or they both die. There is no chance of her dying and the baby surviving. Emma declares she won't consent to an abortion and tells House he has two days to figure it out.
House wants Cuddy to order an abortion, but Cuddy refuses. He claims the fetus is nothing more than a parasite at this point, but Cuddy says they need to exhaust every avenue before aborting. Cuddy gathers the team to run a differential, asking if their original assumption could be wrong. Desperate for a possible solution, Cuddy asks if the liver problems could have developed after they cured the urinary blockage. Cameron and Chase mention acute fatty liver, viral hepatitis and HELLP Syndrome as possible causes. Foreman points out that Emma's platelets are too low. If they biopsy the liver, they won't be able to stop the bleeding. Cuddy mentions transjugular hepatic biopsy. If they go into the liver from above and it does start to bleed, then the blood will go right back into her veins. Impressed, the team heads out.
Chase and Foreman thread a needle through Emma's veins. When they pierce the liver, her heart rate and blood pressure spike. The fetal heart rate explodes to 185 and contractions begin pre-term labor. Later, the doctors tell Cuddy they were able to control the pre-term labor with tocolytics. But the liver biopsy was negative, which means it is definitely Mirror Syndrome. The doctors insist that there's no solution outside of termination. Cuddy suggests overloading the fetus with corticosteroids in an effort to speed up the lung development. Then they can look at the lungs in search of a problem. The doctors rattle off a long list of developmental and practical problems a corticosteroid bath would create, but Cuddy is undeterred. She rushes out to perform it herself.
During the procedure, Emma develops a pulmonary edema, just as the doctors predicted. Wilson enters at the behest of the team. He also advises termination. All Cuddy has done is turn Emma into an incubator for a dead fetus. Cuddy tells Wilson to get out.
The next morning, Cuddy shuffles into Wilson's office with an admission that they were all right. Emma is getting worse faster than the baby is getting better. Cuddy asks Wilson what House would do in this situation. Suddenly, she has a revelation. Since Emma is already on a respirator, it doesn't matter what Cuddy does to her lungs and she can actually increase the corticosteroids. It also sounds like a risky flight of fancy that House would attempt.
The gamble works and Cuddy gets a viable MRI of the fetus' lungs, which she rushes over to House's apartment. The MRI presents many possibilities. House blows off his airport cab for vacation and returns to the hospital. The problem facing the team is that all of the normal lung tests -- transesophageal echo, high-res CT scan, ventilation perfusion -- are impossible to perform on a fetus. Frustrated, Chase blurts out that what they would normally do if stuck is perform exploratory surgery. House thinks that sounds like a good idea.
House plans to open the uterus, then open the fetus itself to take a look around. Despite Cuddy's warning that this procedure is incredibly dangerous, Emma sees a real-time 4D scan of her fetus and emotionally consents. The observation deck is packed for the surgery. When House cuts into the uterus, the fetus's arm emerges, tenderly grabbing House's finger. House freezes, staring at the tiny hand in awe. Despite his earlier insistence that this is a fetus and not a baby, he seems moved by the moment.
Later in the surgery, the fetal surgeon spots three lesions in the lungs and pronounces it to be C-CAM. He thinks he can reset them. Suddenly, Emma begins to crash. Cuddy tries to shock her back to life. House declares that the surgery isn't crashing Emma. It's the fetus. He grabs a pair of scissors and heads to the womb. Cuddy orders him to step back or get electrocuted. House continues working, but sees Cuddy isn't bluffing. He jumps back right before she delivers another shock. Finally, Emma's heart rate returns to normal.
The surgery is a success. House performs a follow up exam on Emma and everything is just fine. Emma thanks him, but House admits that the pregnancy would've been terminated if he had his way.

House, MD Season 3 Episode 316: Top Secret

Outside of Baghdad, a military convoy is intercepted by an IED blast. A Hummer is tossed on its side, and a Marine whose leg was blown off below the knee is dragged from the wreckage. The Marine is House. He is startled from his dream by Cuddy knocking on the office door.
She has a new case -- a former Marine who thinks he has Gulf War Syndrome. House objects that there is no such thing, but Cuddy explains that the soldier is the nephew of a major benefactor. House is forced to deal with this patient whether he wants to or not. Furthermore, the debated existence of the Marine’s disease hasn’t stopped the man’s fatigue, rashes and joint pain.
As soon as he open the file, House is stunned. The attached photo of Sgt. John Kelley perfectly matches the man in his dream who pulled House from the explosion. In the men’s restroom, House recounts the whole thing to Wilson, who thinks it might be a sign. House is skeptical. He is also unable to urinate despite his attempts to do so. He exits the bathroom unrelieved.
The team reviews the case. Foreman and Cameron both concur that Gulf War Syndrome doesn’t exist. Studies show the same pattern of symptoms in veterans who were sent to the Gulf matched those who weren’t. John Kelley, the patient, did not serve in the Gulf War. House thinks Kelley is merely depressed and seeking a disability check. He orders a full physical as well as blood checks for HIV, hep C, malaria, schistosomiasis and T strain A baumanii. House has the team find out all clinics and hospitals the patient has visited and which cities he has lived in. They should also see if the man has ever been on TV.
The doctors perform a variety of exams on Kelley, skeptical about his claims. Kelley launches into a laundry list of his problems. He suffers from fatigue, coughs, rashes, sore throats, joints that feel like they have sand poured in them. His legs sometimes feel cold and other times it seems like his blood is boiling. He doesn’t care what they call his condition, he only wants them to cure it.
The team doesn’t conclude anything based upon the tests. Foreman is ready to prescribe a banana and discharge him. House orders a polysomnogram, theorizing that sleep apnea could cause chronic fatigue and paranoia. Suddenly, House winces in pain, clutching his stomach. Cameron takes notice, but House brushes it off.
The polysomnogram comes up negative. Chase reiterates his theory of uranium poisoning, but they haven’t been able to detect anything in Kelley’s blood. As they wait through the night for Kelley to finish a full sleep cycle, Chase and Cameron retreat to one of the hospital beds for a little romantic entanglement.
Meanwhile, House stands idly over his home toilet, still unable to urinate. His frustration is growing. He shuffles over to the sink and pops a Vicodin.
Foreman drops by the sleep lab, but Chase and Cameron are nowhere to be found. Kelley calls out for help, and Foreman listens to the patient complaining about a terrible smell. Noticing a white substance in the corners of Kelley’s mouth, Foreman takes a look inside. A creamy whiteness coats Kelley’s mouth and tongue. Foreman catches a whiff of the odor. Chase and Cameron finally appear, but too late to be useful.
House sits in the tub flipping through old news magazines, looking for a photo of Kelley that might have triggered his dream. The doctors call with news that Kelley has bacterial vaginosis in the mouth although he claims he hasn’t performed oral sex on anybody in over a year. House instructs his team to have Wilson biopsy Kelley’s salivary glands to check for parotid cancer. And they are to get a more detailed sexual history, because there is no way a Marine abstains for a full year.
The biopsy is inconclusive, and Wilson plans to move onto a sialogram. House figures it’s too late to do anything to save Kelley because the cancer is likely spreading. He asks Wilson for a new prescription, confessing that he hasn’t urinated in three days. Wilson tells him to stop taking the Vicodin, but House doesn’t want to live with the pain. Wilson figures House would be in agony if he hadn’t peed in that long. House counters that he passed agony sometime yesterday afternoon.
Wilson inserts a catheter into Kelley’s parotid gland. Soothing music fills the room to calm the patient during this procedure, and when Kelley asks them to turn it up, the nurses oblige. Despite the increased volume, Kelley complains that he still can’t hear it. Wilson shouts at him, but there’s no reaction. Kelley has gone deaf.
Wilson breaks the news to House that Kelley has brain cancer. He puts the CT scan on the light board, showing at least six tumors. Kelley’s sight will probably be the next to go, and House assumes death can’t be too far off.
House, Wilson and Foreman review the numerous scans on Kelley’s brain in radiology. Chase and Cameron enter after secretly sneaking off for another quickie outside of the hospital. They cover themselves by mentioning that all of Kelley’s stories check out. Wilson asks House if he is having the team research his weird dream. When House doesn’t have a suitable answer, the other doctors walk out, leaving him alone.
As Foreman and Wilson prepare to biopsy Kelley’s brain tumors, House briefs Cuddy that there is no hope for a cure. The questions remain where these tumors came from and why they weren’t detected earlier. Cuddy points out on the VA’s brain scan the surgical pin inserted at the top of neck. The VA didn’t make any mistakes on Kelley, no matter what House thinks.
House has Chase send a sample of Kelley’s urine to a doctor in Leicester who has developed a new technique that allows for greater radiation detection. Then House asks Cameron to call Kelley’s uncle and find out if he ever brought his nephew to hospital functions.
Foreman drills into Kelley’s head using a portable CT scanner as guidance. Curiously, there are now no tumors in Kelley’s brain. Foreman and Wilson share baffled looks. They confer with Cuddy and House to ascertain a possible explanation. Is it an abscess or an infection? Suddenly, Kelley begins screaming that he can’t feel his legs.
The doctors retreat to the meeting room with a list of Kelley’s numerous symptoms. Chase bursts in with the news that Kelley is excreting depleted uranium in his urine. Yet House is no longer interested since they are no longer searching for a cancer cause. House asks for Wilson’s keys and then departs. He’s going home for some sleep.
Standing around monitoring Kelley, Foreman suggests to his colleagues that they follow Chase’s lead and start treatment for uranium toxicity. At home, House inserts a catheter into his bladder through the urethra and finds instant relief. He shuffles to his bed.
Chase and Foreman begin the IV drip. Kelley complains that he can’t feel his stomach. Realizing the paralysis is ascending, Foreman and Chase worry that Kelley will need a respirator soon. Four hours later, House is still wide awake in his bed. He finally gives up at 6 am and gets out of bed.
House finds Chase and Foreman sleeping in the doctor’s lounge. The team moves to Kelley’s room, where an angry Cuddy is questioning who approved the uranium detox. Kelley is now pale and his blood pressure is plunging. House insists that it’s a bleed out and orders a transfusion, despite a clear lack of signs that this is the problem. Chase moves around the bed to help and slips in a yellow puddle. Chase lifts House’s pant leg to reveal a catheter bag with a tear on it. As an incredible amount of urine gushes from the bag, House’s nose begins to bleed. Then House wakes up in his bed at home, finding the catheter bag broken in his bed. He was dreaming.
House goes to the hospital and leads his team to Kelley’s room. He peers into Kelley’s nostrils and finds exactly what he was looking for -- cauterization scars. Kelley cauterized his nose to stop the same nosebleeds that plagued his grandfather. They both had the same condition, Hereditary Hemorrhagic Telangiectasia. The nosebleeds are a result of arteries and veins merging together, which means blood doesn’t get fully oxygenated or filtered. Dirty blood causes the fatigue, infections and joint pain. Further, AVMs in Kelley’s brain caused fake tumors, the ones in his spine caused paralysis and weakness while some in the lungs caused exhaustion. Fortunately, a few surgeries will clean everything up.
House tracks down Cuddy, having finally figured out where he remembered Kelley’s face. Two years ago, Cuddy had brought Kelley with her to a hospital function. She thinks House remembered him out of jealousy. Cuddy tells House to get over her. She hired House when no one else would. House claims that she only hired him because of their “one night.” She again tells him to get over her.
House barges into a supply closet where a shirtless Chase is kissing Cameron. The two awkwardly freeze as House dumps some files into a garbage can. House closes the door and walks down the hall with a smile.

House, MD Season 3 Episode 315: Half Wit

Musical savant Patrick Obyedkov needs his father to help him button his tuxedo in a theater dressing room. Dr. Obyedkov introduces his son, explaining that an accident 25 years earlier caused Patrick to have neurological disabilities. Patrick begins to play the piano perfectly, but it then turns frantic. The muscles in his hands and arm have fully tensed. His fingers start to bend backwards.
House pages the team at five am. Cameron is the first to arrive, but when Foreman and Chase hear that the patient is a 35 year-old savant with dystonia, they’re ready to go back to bed. House comes in, and his interest in the case means that they all must stay. Patrick had been a 10 year-old boy with no prior musical training. After a car accident, he suddenly became a genius pianist. Foreman argues that savantism is just one of those mysterious things, but House orders new labs -- CBC with platelets, chem panel, thyroid and adrenal function tests. They are to look for anything.
As he examines Patrick, Foreman quickly learns that the patient has trouble telling left from right and he repeats whatever people say to him. House has a piano wheeled into Patrick’s room for another test. After he plays, Patrick mimics every note and movement. House asks Patrick to close his eyes then mashes the keys. Patrick perfectly identifies the cacophonous notes. With the hand fixed for now, Foreman and Dr. Obyedkov want Patrick discharged. House wants him to remain, and he orders Foreman to schedule a functional MRI of Patrick’s brain.
The doctors strap Patrick into the FMRI machine. They play some classical music but nothing flashes in the brain. Foreman observes that listening and playing are two completely different neurological processes. House asks Patrick to pretend his leg is a piano and to play it. As his fingers dance on his leg, the FMRI begins lighting up and Patrick’s heart rate rises without the limbic system activating. House tells Foreman that they need to get Patrick into surgery immediately.
As Foreman scrubs up for surgery, Cameron mentions that she found an airline ticket in House’s mail. He is going to Boston. She wonders about an opening for a Division Chief of Infectious Diseases at Harvard. Foreman notes that it isn’t like House to be ambitious, but he did notice House testing blood in the clinic. However, basic medical clearance for employment would require a cholesterol and glucose check.
Since they know that House would never tell them the truth, the doctors decide to borrow one of his favorite moves and break into the subject’s residence. Chase and Cameron go to his apartment. Chase asks if she wants to have a go on House’s bed. Cameron thinks this isn’t the time, but her smile indicates that it’s a definite possibility. Chase comes across a phone bill with multiple calls to a 617 area code. He dials and reaches Massachusetts General Hospital.
Back at the hospital, Foreman is snaking a catheter through Patrick’s femoral artery toward the heart. Patrick’s heart rate begins accelerating to 160, then 210. Foreman has to break out the paddles to save him. The doctors discuss Patrick’s heart attack during surgery. House thinks a sudden bleed might explain both the attack and the dystonia, so he orders a colonoscopy and an upper endoscopy. If that doesn’t show anything, they can also perform an enteroscopy to look at the small bowel.
Tipped off by Chase and Cameron, Cuddy calls Mass General and tells a Dr. Medick that she’s not letting House go without a fight. Dr. Medick assures Cuddy that they aren’t interested in hiring him. Cuddy asks if House might be a patient. Indirectly answering her, Dr. Medick says that neither he nor Dr. Kupersmith can stand House.
Cuddy tracks down Wilson and finds out that Kupersmith’s specialty is brain cancer. Cuddy ticks off some symptoms, wondering why House isn’t showing any signs of cancer. Plus, he hasn’t told anybody. Wilson explains that symptoms take time to show and that most cancer patients keep the news to themselves because they don’t want every conversation thereafter to revolve around cancer.
Cameron catches up with Wilson. He tries to avoid the talk, but Cameron states that if she needs to start looking for work, then she has a right to know. Wilson finds House in his office later and artfully works brain cancer into the chat. House winces, claiming that it’s nothing. Wilson asks to at least see his chart, wondering why House wouldn’t come to him. Chase interrupts with a surgical report. House was right -- Patrick had a bleed behind his kidney, but there’s no cancer or ruptured arteries that would cause it. House ignores this report as he stares at Chase. He knows the cancer news is out. Wilson claims that he only told Cameron.
House gathers the team to confront the cancer question and he assures them it’s not an issue. The team asks him for some blood to double check with tests, but House is only interested in discussing Patrick’s case. Why are his seizures getting worse? House suggests ceasing the anti-convulsant medication to let the seizures really kick in. Maybe that will direct them somewhere. Cameron worries that multiple seizures will only damage Patrick’s brain. House points out that the man’s brain isn’t in prime condition anyway. When Patrick gets worse, they can run a PET scan.
Cameron asks House to sign a letter of recommendation she wrote in his name because she is applying for a job at Penn. House brings up the cancer and Cameron pauses. They move closer to each other and suddenly begin kissing. While their lips are locked, Cameron reaches into her pocket for a syringe. House, sensing the movement, grabs her hand. She pleads that they need his blood for tests. House directs her to his file in the records room. Everything they would want is in there.
Cameron finds the CAT scan in House’s file and takes it to Foreman. He spots a six-centimeter mass in House’s dorsal midbrain extending into the temporal lobe. The brain cancer is inoperable. Foreman figures that House has less than a year to live. The team continues poring through House’s file, noticing that he has a consent form for a drug trial. However, it’s not a cancer treatment but a drug used to treat depression in cancer patients. The procedure involves implanting drug-eluting chips into the pleasure centers of the brain.
House brings the team Patrick’s PET scan, which reveals several more hot spots in no distinct pattern. The left brain is working harder than the right. Cameron pronounces bleeding in the brain. House goes to perform an angiogram to look at the vasculature in the brain. House notices tiny dots. The MRA confirmed small collections of blood throughout the white matter of Patrick’s right hemisphere. That could be trauma, an aneurysm, cancer or autoimmune disease. They will need a biopsy of all parts of the brain. The team argues that House can’t just randomly pluck out pieces of a patient’s brain. Foreman suggests an internal EEG. An external test can get confused, but an EEG from inside the skull would reveal exactly where to biopsy. It’s risky, but worth it.
Later, Foreman finds House alone in Patrick’s room. Before he hands over the test results, Foreman wants to discuss something personal. Despite House’s attempts to drive everybody away, Foreman still likes him. He turns back to the patient’s EEG. There are no electrical abnormalities. What it did show is that Patrick’s entire right hemisphere is brain dead.
House mentions that Patrick is left handed and can still speak, so perhaps the right hemisphere still has some random neurons firing. House and Foreman head to Patrick’s room with a small electronic piano. Foreman covers Patrick’s right eye and asks him what’s on the table. Patrick identifies the piano. Foreman then covers the left eye and asks again. Patrick has no idea. House plays a few bars of a tune and then spins the piano around to Patrick. He plays it perfectly. The doctors exit. In the hallway, House argues that Patrick’s right brain has always been damaged. Yet this is irrelevant to the current issue. Foreman realizes this means the problem is autoimmune and they can begin treatment.
Chase finds House in his office and asks to chat. House sighs at another emotional moment. Chase ignores him and hugs House. Then he says that Patrick is responding to treatment. Unfortunately, now comes the next step. House rings Cuddy’s doorbell in the middle of the night. House lets her know that Patrick has Takayasu syndrome, which Cuddy points out is manageable with steroids. House wants a hemispherectomy since the right side of Patrick’s brain is basically useless. It would stop the seizures. Cuddy responds that they will need to ask Dr. Obyedkov about his son’s treatment.
House appeals his idea to Dr. Obyedkov. With the right brain removed, the left brain could stop compensating and function on its own. Patrick would begin learning new things but would lose the ability to play the piano. Dr. Obyedkov argues that Patrick is doing fine and that he doesn’t mind taking care of his son. House counters that he has made Patrick into a trained monkey, but that this procedure would allow him to grow into an adult. Is Dr. Obyedkov is afraid to let him go?
Dr. Obyedkov asks his son if he’s happy. When Patrick merely repeats his father’s words, Dr. Obyedkov picks up the phone to grant consent for the procedure. The hemispherectomy is performed successfully.
The doctors study a scan of House’s brain, hoping to get him approved for a clinical trial. Unfortunately, he is negative for protein PHF and thus doesn’t qualify. Suddenly, Chase notices something odd on the scan. They rush to House’s door and announce that he doesn’t have cancer. There was an abnormal presence of IgC and IgM in his brain, plus a gumma, which is usually found in the liver. House mentions that he doesn’t have syphilis because his VDRL was negative. The team did a new test, which means that House got a false negative. House pauses and asks if they sent the results to Mass General. When they admit they did, he calls them idiots.
It wasn’t his file. House tells them that the real patient is in the Witherspoon wing of Princeton-Plainsboro. They can tell the man’s wife that he’s not dying of cancer but is cheating on her. The doctors angrily ask if House was faking cancer. He wanted the doctors at Mass General to think he had cancer so that he could take part in the drug trial that places an implant in the pleasure center of his brain. Exasperated, Cameron asks House if he faked cancer to get high. The doctors stumble away in shock.
The next day, House does a follow up on Patrick. He doesn’t respond to House’s verbal cues, but then Patrick buttons his own shirt and smiles.
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House, MD Season 3 Episode 314: Intensive

A woman named Cynthia drives her daughter Hannah to the hospital because she slipped on ice. Hannag insists that she is fine. As they speed through a snowstorm, the car is broadsided. With Cynthia unconscious, Hannah dials 911 with a cell phone. The dispatcher asks Hannah is she has any injuries. She looks down, sees a metal rod jammed into her thigh and says she’s fine.
At the hospital, Foreman examines Hannah, who’s only worried about her mother. House comes by as Foreman is cleaning her wound. When Hannah winces at the soaked gauze, House studies her. He immediately figures out that she has CIPA -- congenital insensitivity to pain. It is one of the rarest conditions on the planet, with only about sixty documented cases. They will need to x-ray to check for internal injuries. Foreman is skeptical, so House whacks Hannah in the shins with his can. Her delayed reaction, followed by her slumped shoulders, tells the doctors everything they need to know.
House petitions Cuddy to let him run tests on Hannah. When she learns about the CIPA, Cuddy realizes that he only wants to find out about his own pain through Hannah’s illness. House doesn’t deny it, and he keeps pressing Cuddy about the tests. She agrees to x-rays, blood tests and an EEG. Yet she refuses a nerve biopsy, which runs a risk of paralysis. If the EEG shows a problem, then they can talk further.
The doctors try to run an EEG, but it is rendered useless when Hannah screams to see her mother the entire time. They tried to sedate her and couldn’t hold her down. She is strong and has no fear. House goes in to see Hannah and he starts trading notes with her on their respective conditions, arguing the difficulties they each face living a life of either constant pain or none at all. When Hannah turns around to show House a scar from sitting on the stove when she was three, House stabs her with a syringe loaded with sedative. He instructs his team to finish the test.
Hannah awakes and Cameron explains that all of the tests came back negative. Suddenly, Hannah’s eyes roll back in her head and she collapses. Her temperature is 105. The team analyzes possible causes for Hannah’s fever, coming up with nothing tangible. House suggests running a biopsy on the spinal nerve, so he goes to request Cuddy’s permission. House tracks her down on a blind date at a coffee house and again asks for a nerve biopsy. Cuddy initially resists, but when House presses the issue she acquiesces.
Chase and Cameron observe surgery on Cynthia, who is not faring well. They decide to keep Hannah in the dark as long as possible. Foreman comes in to discuss House bulldozing a path toward a spinal biopsy, which is a procedure they’re greatly opposed to. Chase figures the only chance they have to stop him is if they find the answer first. In an attempt to determine the problem, Chase suggests overloading Hannah’s pain receptors until something starts reaching the brain.
Chase hooks Hannah up to a PET scan and has her stick her hand back and forth between two containers of hot and warm water. The test begins and Hannah asks about her mother. Distracted, she leaves her hand in the hot water. By the time Chase is able to pull her hand out, Hannah has second-degree burns.
They put Hannah in a surgical chair with a stereotactic frame screwed into her head to prevent her from moving. She is wired to a series a monitors. Foreman withdraws a needle from Hannah’s skull, announcing that he has injected kinase proteins which will replace missing chemicals in her brain and perhaps trigger a response. Another doctor begins drilling into her skull, and Hannah casually chats with Foreman throughout the procedure. Suddenly, her eyes open wide and she starts screaming. Foreman immediately stops the procedure and asks Hannah where it hurts. Hannah smiles, pushes him over and runs out of the room.
Wilson confronts House about Hannah because he is convinced House is only keeping the girl in the hospital so he can study her. Although House claims he is merely curious, Wilson isn’t having it.
Hannah goes to the lobby balcony in order to jump. Cameron pleads with her to come down from the railing, explaining that she’s having a paranoid delusion. Hannah claims that she can’t feel her legs, then tumbles to the floor below.
That night, Hannah sits in bed looking perfectly comfortable. Cameron rattles off the list of her ailments: six broken bones, a concussion, a fever, erratic heart rate and total numbness below the waist. Hannah smiles and says she feels fine. She asks if her mother is out of surgery.
The team examines Hannah’s x-rays. Since her spine is clean, they figure temporary paralysis was caused the fall. House allows the paranoia and paralysis to lead him to a neurological issue, so he once again suggests a nerve biopsy. Cameron jumps in with the idea of a thyroid storm, which House is unable to rapidly shoot down. Foreman points out that this thyroid storm makes sense, given her glucose reaction is slow and her potassium is down. House is stuck to disagree, so he calls for an endocrinologist.
House drops by Cuddy’s place with the file. She asks why he didn’t call Dr. Bennett, the endocrinologist on call. House claims that he did but that Bennett didn’t pick up. Bennett’s phone must be broken. Despite the fact that she’s in the middle of another date, Cuddy reads through the file and shoots down the possibility of a thyroid storm. Then Cuddy steps close to House and asks if he likes her. House is thrown, and he has no answer. Cuddy joyfully points out that she spoke to Dr. Bennett fifteen minutes ago. She finds it interesting that House feels the need to constantly drop in on her when she’s on dates.
House returns to the hospital with confirmation that it’s not a thyroid storm. He notices that some papers are missing from his desk, so he walks directly to Wilson’s office. The team trails him, repeating their warnings about the risks of performing a nerve biopsy. House demands his papers back from Wilson, who asks for some privacy with him. Wilson refers to the article, mentioning that researches recently found a protein that speeds up nerve growth. If that protein was insulated with spinal nerve, it could create a nerve garden. If that spinal nerve came from a CIPA patient, then a doctor might be able to grow pain-free nerves and perhaps graft them onto his own leg. Wilson points out that he would be risking the patient’s life, but House counters that the idea is justified. Wilson wants to know whether House really thinks he’s the one who should be making this call. Finding his team waiting in the hallway, House instructs them to biopsy whatever nerve they think they can extract with no risk.
After they take a biopsy, Foreman and Cameron are confused because CIPA shouldn’t cause this much degeneration. They call in House for a consult. The insulation around the nerve fibers has basically been stripped, meaning the damage is coming from the outside in. House pronounces it secondary demyelination, which means it is not a nerve disease but more likely metabolic. Cameron walks out of the discussion in order to take Hannah to see her mother, who just came out of surgery.
Seeing her mother is quite stressful for Hannah, and when her mother is taken away for a second surgery she cries over a pain in her head. Unfortunately, this tells the doctors nothing because the pain is emotional. House adds guilt to the white board of potential metabolic symptoms, which could be caused by a vitamin B12 deficiency. Yet Foreman notes that the hospital administered B12 as part of a multi-vitamin supplement when Hannah was admitted. House’s theory is going nowhere.
House visits Wilson to complain about again being stymied in Hannah’s case. House takes a bite from Wilson’s sandwich. Wilson jokes that he derives pleasure from beating other hunters to the food. Suddenly, House has an idea.
He rushes into the procedure room where Chase and Foreman are about to sedate Hannah. House grabs the mask, mentioning that nitrous makes a B12 deficiency worse. Foreman again points out that Hannah already received a B12 supplement. House is convinced that somebody else already ate it first, alluding to his conversation with Wilson. House calls for an abdominal MRI. Hannah begins freaking out with another paranoid delusion. House barges into an OR with her.
House cuts into Hannah’s stomach without any anesthesia, and he pulls out a floppy, wet, white worm. He continues pulling and pulling, eventually removing the entire 25-foot parasite. A worm like this would have caused anyone else tremendous pain since it would have sunk its numerous claws into the intestinal wall to lock into its host.
That evening, Cameron remembers that it is Valentine’s Day and she invites Chase to come to her place. Chase questions whether or not she is settling because she is feeling lonely. Cameron tells him to forget it.

House, MD Season 3 Episode 313: One Day, One Room

Cuddy orders House to two days of nothing but clinic duty. He starts by assembling the many who think they might have an STD. Then he ambles out to the waiting room to see how many patients are left. Suddenly, a man clutches his ear and runs around, screaming in agony. House trips the man with his cane, holds him down and administers a paralytic agent. The man becomes frozen, but at least he's no longer making noise. Unfortunately, they need to intubate because the paralytic has stopped the man's breathing.
House gathers his team to discuss the man's case. House asks what right ear pain, psychotic behavior and dizziness might indicate. Foreman throws out an acoustic neuroma that started to hemorrhage, so House asks for an MRI. Chase mentions that the man could have been psychotic first and mutilated himself. House likes that idea too, and he asks for a full psych work up. He then tells the doctors to pour some alcohol into the man's ear and pull out the cockroach. House knew this was the cause all along. He only wanted a big case to get him out of clinic duty.
Cameron, making the rounds on clinic duty, sees an old, disheveled man who's most likely homeless. He hands her a note and says that the other hospital gave it to him but he cannot read. The note says that the man has a six centimeter cancerous mass in his right lung which is inoperable. The man asks if he can sleep in the hospital because it's cold outside. Cameron finds Cuddy and spills the truth about House and the cockroach patient. Cuddy angrily tracks House down and makes it clear, once again, that either he does clinic duty or she will confess about the evidence against him. He owes her.
House returns to clinic duty and announces to the waiting room that he'll give $50 to anybody who leaves without being seen. Cuddy pulls him back into her office, desperate for a solution. She offers House $10 for every patient he can diagnose without touching. However, he will have to pay her $10 for every patient he does have to touch. So House starts plowing through patients without touching any of them.
The test results come back from the earlier STD patients, and the first two are clean. The third is a 20-something blonde female named Eve who tests positive. Eve breaks down in tears at the news even though House reassures her that Chlamydia isn't all that bad. House tries to hand her some pills, but Eve yells at him to not touch her. House goes to tell Cuddy to get a new doctor for this patient. Eve has been raped.
Cuddy explains to Eve that the hospital will assign another doctor, but Eve insists on House. House says that he isn't interested in treating her because there is nothing to treat. She is perfectly healthy. Eve doesn't care, and only wants to talk to him. House comments that she just wants to reclaim power after being raped. Eve screams at him to leave.
Eve crashes in the clinic. Cuddy and another doctor attend to her, but she is unconscious and foaming at the mouth because of a pill overdose. The doctor tells House that she had talked to Eve for over an hour but the girl said nothing. When the doctor turned her back, Eve grabbed the pill bottle.
House waits for Eve to awake and he asks her what she wants. She only wants to talk to him - about anything. House goes to his team for advice, and they suggest he give the girl his conversation. Cameron angrily says that there is no way that Eve can pretend the rape did not occur. She needs to process it. House returns to Eve and explains to her that she can't blame herself for this. Eve says that she knows that already, but she still wants to talk about nothing.
Cameron's homeless patient is hooked up to a battery of machines and IVs. He pleads with her to stop the treatment because he doesn't want it and doesn't think he deserves it. Although she disagrees, Cameron unhooks the equipment. She visits him later and questions why he wants to suffer. The man asks her why her husband had to suffer. Cameron demands he tell her how he knows about her husband. The man admits that the nurse told him.
House and Eve discuss where they went to college. House still gets no answer on why Eve trusts him. She inquires whether anything terrible has ever happened to him. He hesitates, so Eve flips his own logic back on him. Not knowing what to do, House leaves to go seek counsel. Wilson thinks he should just tell Eve the truth. Cameron advises House to say his life has been wonderful so that the girl has some hope. Foreman suggests he just admit that his life has sucked so that she will see that she too can rebound. Chase notes that there is no wrong answer.
House returns to Eve's bedside and starts into his life story. He says that he was abused by his grandmother. His parents traveled and often left him with her. She was a strict disciplinarian. House never misbehaved when she was around because he was too afraid of being forced to sleep in the yard or of being made to take a bath in ice. He never told his parents. Eve asks if any of his story is true, and House assures her that it all is. She again asks if it is true. House replies that it is the truth for somebody.
Cuddy lets House know that Eve is pregnant. He breaks the news to the girl, then offers her the chance to terminate it. Eve isn't interested because she considers abortion to be murder. House asks her if she wants to take a walk outside to get some air.
Meanwhile, Cameron's homeless patient is still suffering. She tries to force pain medication on him, but he resists. The man says that if he dies suffering, then Cameron will always remember him. Nobody else will remember him. Cameron leaves the syringe next to his bed and sits down across the room. The man later struggles for breath and dies.
House and Eve sit in a park watching people jog by. They continue their philosophical discussion. Eve argues that eternity is what we live for, and House believes that our time on Earth is all we have. Eve refuses to believe that because then there are no ultimate consequences. She needs the comfort of knowing that this all means something.
Eve wonders if her attacker feels remorse for his actions. House asks why that matters. He then inquires why she trusts him. Eve explains that there's something about him, as if he is hurt too. House confesses that his story was true. Yet it wasn't his grandmother but his father who abused him. Eve begins to acknowledge what happened to her to House.
Back at the hospital, House informs Cuddy that Eve terminated her pregnancy and has been discharged from the hospital.

House, MD Season 3 Episode 312: Needle In A Haystack

A sixteen year-old named Stevie is making out with his girlfriend Leah in a car when he has a hard time breathing. He turns blue.
House takes his car into work because of the weather, but when he pulls into the hospital lot he finds that the handicapped parking space closest to the building is already occupied. There is a sign over the space that reads "J. Whitner, MD." House has been assigned a more distant space than he had before, and Whitner has his old spot.
Foreman approaches House about Stevie's case, but House is more interested in the new parking situation and the identity of J. Whitner. Cameron explains that Dr. Whitner is a new female researcher confined to a wheelchair. Foreman tries to get him focused on the case, pointing out that Stevie suffered respiratory arrest with no history and that his ER work-up showed a bloody pleural effusion. That last part finally grabs House's attention. House suggests a blood leak and orders a veinogram.
House tracks down Dr. Whitner in the research lab. Since her wheelchair is motorized, he figures there must be some parking mix up because he has to walk while she only needs to push a joystick. Whitner points out that it's hard for cars to see her so the parking lot is dangerous. She won't be giving the spot back.
As Stevie struggles with breathing and chest pains, Foreman is unable to track down the boy's parents to sign consent forms. Leah offers to have her parents sign, but that's not legally viable. Stevie claims his parents are probably at a conference and had to shut off their cell phones. Suddenly, his oxygen stats plummet. Foreman has no choice but to perform the veinogram now. He will deal with the fallout later.
As Foreman begins the procedure, Stevie notices a diffusion pattern on the monitor and declares that it is Graham's law. He figures the leak has to be in his pulmonary veins in order to get into his lungs. Impressed, Foreman asks if he is studying this in high school. Stevie claims to read things on his own, and then he quickly changes the subject. When nothing shows up on the test, Stevie wonders how he can have a bloody effusion without any bleeding.
Cameron and Chase go to Stevie's home to look for drug use. The first thing they find is rotting food in the kitchen. Chase sees two people having sex in one of the bedrooms. The couple has no idea who Stevie is.
The doctors confront Stevie about the address he supplied. He tries to cover, but they know he's lying. Leah finally admits that Stevie is Romani, which is a gypsy. Stevie explains that the doctors cannot go to his home because their mere presence will spiritually pollute it and his parents treat that very seriously. He promises to tell them anything they need to know as long as they don't go where he lives. His family earns its living by buying and selling anything they can. Stevie was just in Chicago with his father last week on such a venture.
House confronts Cuddy about the parking issue and the debate quickly devolves into a bet. Cuddy predicts that House couldn't last one week in a wheelchair. He accepts the challenge. The team spots House rolling around the lobby and they update him on the case. Stevie's veinogram showed no leakage, and none in the lymphatics. House, adamant that blood outside the circulatory system could only come from a leak, advises his charges to stop trusting Stevie's claims and find some answers on their own. Either that, or they can thin out his blood for another veinogram.
Taking matters into their own hands, Cameron and Foreman perform an arteriogram first. Foreman suspects deep vein thrombosis from Stevie's recent long drive to and from Chicago. Cameron begins inserting a tube into a leg artery and Stevie cries out with stomach pain. The dye Cameron injected is entering Stevie's liver but not leaving it. The liver is completely blocked.
The team reconvenes with House, who sticks with his leak theory. Figuring a mass could be poking holes in Stevie's arteries, House asks for a CT, an MRI, a sputum and an ACE level. Then he wheels off. Stevie, who's beginning to turn yellow, enters the MRI. Foreman laments that Stevie's intelligence is being wasted by parents who are forcing him to sell scrap material. The doctors think they've spotted a granuloma on the MRI just as Stevie's parents barge into the room.
Foreman tracks down House in the parking lot and breaks the news about the granuloma. They now know it's Wegener's. House, encouraged by the development, tells Foreman that a liver biopsy will take too long. They need to start treatment with cyclophosphamide before things get worse. House then lifts himself from the wheelchair to his car, asking Foreman for help folding up the wheelchair. Foreman refuses and walks back into the hospital.
Foreman checks up on Stevie and notices that the parents Franklin and Constance have taken over the room, providing him with their clothing, their blankets and their food. Foreman chafes, noting that the hospital needs to control the environment in order to know if the tests are working. Stevie's parents argue that their son's life is simply out of balance and they're helping to restore it.
Later, Foreman returns for another checkup and finds Franklin and Constance shouting at Leah to get out of the room. They blame her for Stevie's troubles. Stevie begins to moan in agony. When Foreman pulls back the blankets, a large bloodstain covers Stevie's groin.
The team reports to House that the treatment for Wegenger's caused a massive hemorrhage in Stevie's bladder. House thinks that's good, which baffles his team. Everything else is ruled out. They have the correct diagnosis but the wrong treatment. They need to change the immune system, and House mentions an experimental drug named FT-28. Stevie's immune system is attacking his blood vessels. They can change his immune system so that the drug doesn't react to the blood vessels but works everywhere else. Cameron, ever mindful, points out that FT-28 isn't FDA approved. It has, however, worked for Crohn's disease. House suggests that they say Stevie has Crohn's so that they can administer the drug.
Franklin and Constance flatly refuse to allow the hospital to experiment on their son. Franklin mentions the medical experiments at Auschwitz and Foreman counters with the Tuskegee experiments. With no gains made in the argument, Foreman consults with House who advises him to become a better salesman. He must somehow earn the family's trust.
Stevie's extended family is now in the patient room and there's a festive, happy air. Foreman hooks up a new IV and then asks the family to give them some privacy so he can change the bandages around Stevie's groin. When the room is emptied, Foreman explains to Stevie that the doctors want to alter his treatment but that his parents won't let them. Stevie realizes that their resorting to experimental treatment means they must be out of answers. How can he trust Foreman? Foreman gives him the medicine and instructs him not tell his parents. If they find out, then Foreman will lose his license. That's how he knows he can be trusted. Stevie begins writhing in agony from intense pain.
A surgeon removes Stevie's ruptured spleen and gives it to Foreman to perform a biopsy for Wegener's. House watches from the observation deck in his wheelchair. He doesn't spot anything out of the ordinary or granulomas. House asks them to run Stevie's bowel, but the surgeon begins closing him up. House needs to get downstairs quickly, but he also needs to win his bet. The elevator is taking too long, so House bounces his wheelchair down the stairs and barges into the OR, insisting that a granuloma is indeed present. House stands up and sticks his gloved hands into Stevie's body to feel the small intestine for granuloma. The surgical team immediately stops working in fear of a lawsuit. House reaches the end of the small intestine and finds nothing. There is no granuloma. Stevie's parents were right.
House and his team head back to the drawing board. Still suspecting the bowel, House orders a colonoscopy. They will need to move fast because Stevie is in the ICU, which has limited visiting privileges. The doctors must get to Stevie before the family cuts off their access. The colonoscopy, like everything else, comes out normal. Suddenly, Foreman spots a toothpick. Stevie chews on them like his father does. He must have accidentally swallowed one. During his make-out session, an awkward movement could've pushed the toothpick through the colon wall and into the lung. From there, it traveled to the liver, then the kidney, then the spleen.
Franklin processes this news, then immediately blames Leah. If she wasn't kissing Stevie, this never would have happened. Leah blames Franklin for passing such a disgusting habit on to his son. Foreman visits with Stevie and says he will be fine in a few days. Foreman then mentions that the hospital lab has a paid internship which is usually given to a university student. He promises to arrange an interview for him. Stevie thanks him but passes on the offer. Foreman implores him to put his mind to use, but Stevie notes that Foreman, Cameron and Chase are all single and alone. Stevie wants a family.
House goes to reclaim his parking spot from Cuddy, but she knows that he stood up in the operating room. He lost the bet. House accuses Cuddy of never planning on giving him the space. That would explain why Dr. Whitner wasn't concerned about losing her parking when House confronted her earlier in the week. House asks Cuddy if she feels even a little bit guilty about her scheme.
That night, as he leaves the hospital, House sees a maintenance worker putting his name back on the spot closest to the building.

House, MD Season 3 Episode 311: Words & Deeds

As emergency workers struggle to douse a raging blaze, a firefighter named Derek Hoyt walks out of the burning building intact. Suddenly, he gasps for air and becomes delirious. When he staggers back towards the building, he complains of being freezing.
Cameron examines Derek, who is covered in skin grafts. His last procedure was six months ago. His body temperature is wildly swinging up and down. She wants to refer him to House, who is currently at a preliminary hearing pleading not guilty to all charges. The judge sets an evidence hearing for a later date.
Back at the hospital, House gets the details on Derek's case. Thinking of the skin grafts, Chase suggests a hospital-acquired infection. House orders a blood culture and a round of antibiotics. Cuddy summons House to her office and orders him to talk to Tritter. She blames the entire situation on House. Tritter kept setting traps for him, and House continually fell into them. House actually seems somewhat chastened.
Cameron visits Derek and explains they think he has Mercer Disease, a common bacterial infection contracted in the hospital. Derek asks if Mercer makes everything look blue. Cameron immediately realizes that it's something else entirely. House suggests male menopause or really high estrogen and low testosterone levels. He instructs his team to run a hormone panel.
The doctors attempt to draw blood from Derek, but when they get the needles into his arms, he freaks out and demands that they be removed. He grabs Cameron and begins choking her as Foreman tries to restrain him. Foreman injects a sedative and Derek goes limp.
A very contrite House pays a visit to Tritter. He admits that he can be described as anything from arrogant to unhinged, but he has to act that way because of the constant, crushing pain he deals with. His pain can be described as intolerable only on a good day. He knows that he has handled it incorrectly. Tritter thanks him, but is sure that House didn't mean a word of it. Tritter says he will see him at the hearing.
Back at the hospital, the team updates House on Derek's case. They insist it has to be neurological. Foreman wants a CT for a frontal lobe tumor and an LP for meningitis. An absent House agrees and leaves. The team chases after him, wondering why he isn't shooting down their ideas. He says it is because he has to go upstairs and check himself into rehab.
Without House, the team starts their first differential diagnosis. Cameron immediately wants to consult House, but Foreman and Chase think this is their chance to grow up. And with House undergoing detox, he won't be much help. Chase recalls an old House comment: "Everybody lies." With all of the skin grafts Derek has had, he must be in tremendous pain. He must be hiding his pain to keep his job. They need to find the pain. Suddenly they are paged. Derek cannot breathe.
Chase quickly recognizes a heart attack and they stabilize him, but realizes it won't last long. Derek has been hiding a series of chest pains. Now they have to figure out what's causing these attacks. Cameron goes to see House and finds him puking in his rehab dorm room. House advises them to look for an external or environmental cause that all three attacks share in common.
After some thought, the doctors summon Derek's firefighting partner, Amy. Derek then suffers another attack. The doctors perform a battery of tests on Amy, who's clean of any spores, molds, toxins or possible physical causes. Cameron asks Derek if he's in love with Amy. He is unable to admit to it because Amy is engaged to his brother.
The team reports back to House to figure out a plan. When they theorizes that the only way to cure Derek is to end his love for Amy, House has a radical solution. They can fry his brain to clear any thoughts of Amy. A procedure like that will need Cuddy's permission, and the doctors are actually able to talk her into it.
Cameron explains the planned procedure to Derek. This electroshock therapy will wipe out Derek's memory. His feelings for Amy, his firefighter training and his childhood. Cameron begs Derek to tell Amy how he feels. If not, he's choosing to wipe out his entire life for a secret.
Tritter pays a visit to House in rehab because Cuddy goaded him into it. He's still not going to talk to the DA. House rails that Tritter's word means nothing. Tritter says he'll never trust an addict, and even House's actions lie.
The doctors perform the procedure on Derek and then test his mental faculties. They bring Amy and his brother in. Derek has no memory of either of them. The team informs House that everything has basically worked out. Later, Cameron and Amy observe Derek through a window. Cameron congratulates Amy on her upcoming wedding, but Amy has no idea what Cameron is talking about. She's not marrying Derek's brother nor do they even date.
The doctors place an emergency call to House, who's at his evidence hearing. Derek's memories were false. They fried his brain for nothing and whatever was plaguing him is still there. They talk through the symptoms and House orders his team to set up Derek with a selective vertebral angiography. As House limps out of court, the judge threatens to find him in contempt. He leaves anyway.
House has realized that all of Derek's issues go back to the initial thoughts on menopause. The test reveals spinal meningioma pressing on an artery and affecting Derek's brain. They need to schedule surgery to remove it.
At the trial, Cuddy is on the stand when House barges back in. The DA shows Cuddy the pharmacy log and asks if this indicates that House stole oxycodone from Wilson's dead patient. Cuddy explains that it does not. The DA states that Cuddy testified earlier that it did, but she presses on. Dr. Wilson informed her that House had tried to steal the same patient's oxycodone before, so Cuddy went down to the pharmacy and swapped out bottles. House stole a placebo. She has a pharmacy inventory report reflecting her order. Tritter vehemently protests that this report is obviously forged. The judge asks why Cuddy didn't come forward with this evidence earlier. Cuddy admits that she never thought it would come to this point. The judge, while making a point to chide House, declares that Tritter tried to make an example out of House and dismisses the case based on both Cuddy's testimony and her efforts to protect House. However, House is still guilty of contempt for walking out earlier, so it's a night in jail for him.
As the bailiff leads House out, Tritter stops him. House bristles for a threat, but Tritter merely wishes him luck and says he hopes he's been wrong about him.
At the hospital, Cameron explains to Derek that this latest treatment has worked. He can move on and begin creating new memories.
That night, Cuddy and Wilson visit House in jail. Cuddy is angry that House forced her to forge evidence and perjure herself. She makes it clear that she owns him now. It may entail clinic duty, unruly patients or extra hours. Whatever she wants, he's going to do it. She walks off. Wilson slips House a cup of medication from the rehab supervisor. House greedily gulps it down. Wilson realizes that the rehab supervisor has been slipping House Vicodin. House smiles, proud of his scheme. Wilson, distraught and despondent, worries that nothing has changed.

House, MD Season 3 Episode 310: Merry Little Christmas

House limps into the hospital on a snowy day. The Christmas decorations in the lobby do not warm his icy heart. Neither does the sight of Wilson and Tritter waiting for him. Wilson explains that he worked out a deal after he told Tritter that he didn’t write the prescriptions. The D.A. is offering House two months in a rehab facility in exchange for a guilty plea. House coldly tells them to get out of his office. Tritter says that he only has three days to make a decision.
House barges in on Cuddy as she is seeing a clinic patient, who is a 15-year old dwarf named Abigail. The mother of the girl, Maddy, is equally diminutive. House demands his pills from Cuddy and offers to take the case in exchange. He rudely assumes that it is relatively simple because the girl has a popped lung. Maddy notes that both she and her daughter have Cartilage-Hair Hypoplasia. House grabs the case file, again asks for his pills and retreats to the office to find his team.
The team would rather talk about Wilson’s deal with Tritter, and they think House should take it. House moves on to the unexplained lung collapse and anemia. Realizing that many dwarves have compromised immune systems, rendering most tests inapplicable, House schedules a gallium scan.
Cameron explains to Abigail that gallium is a radioactive isotope that will travel through her veins. Any bright spots that show up could indicate infection. While Cameron is setting up the test, House and the mother continually fire jabs at each other. Maddy gives just as good as she’s getting. House is quite amused and intrigued by this little firebrand.
Cuddy upbraids Wilson for making a deal with Tritter without consulting her first. He knows that House will never take any deal. Wilson suggests they stop House’s Vicodin supply. When the pain becomes unbearable, offer him pills in exchange for taking the deal. Cuddy worries about the effect House’s detoxing with have on his patient.
The gallium scan on Abigail shows nothing. Although House thinks the liver scans out, every part of the girl’s body is glowing brightly in the scan except for the liver. Why? Cuddy rips into the office and announces that House is off the case. Furthermore, his treatment privileges have been revoked until he accepts Tritter’s deal. She’s also cutting off his Vicodin and taking over Abigail’s case herself. Her first order of business is an MRI of Abigail’s lungs. The team exits and House warns Cuddy that she’s going to come to him begging with help on the case long before he comes to her begging for pills.
The MRI is clean, but Abigail begins vomiting blood during the test. House was right about the girl’s liver failing. The team will perform a liver biopsy in search of cirrhosis, hepatoma or other causes. Foreman sneaks word to House that his thoughts on the liver were accurate in the hopes that House will point him in the right direction. House offers him one theory in exchange for Foreman jimmying open one drawer for him. If that drawer just happens to be where Cuddy is hiding Vicodin, so be it. As Foreman works to pick the lock, House explains that the problem Abigail has is global. It started in the liver but will spread in short order. He should focus on the pancreas. House eagerly opens the drawer, but there’s no Vicodin inside.
Cuddy returns with the results on the test that Foreman ordered. It was negative. Cuddy and Wilson are quite aware that Foreman was led in this direction by House. The liver biopsy indicated severe duct inflammation, so it’s time to turn their attention back to the liver.
House sits in an examination room at a 24-hour clinic. He claims he had a fall and Princeton-Plainsboro discharged him with directions to a clinic. The clinic doctor offers some pain medication and House invents various reasons that different prescriptions won’t work to steer the doctor toward Vicodin. However, the clinic isn’t allowed to prescribe opiates to new patients. Enraged, House rails that gabapentin -- the doctor’s original drug recommendation -- is for nerve damage. Realizing that House is a medical professional, the clinic doctor calls security. House shuffles out.
Foreman and Wilson prepare Abigail for her next liver test, but she falls unconscious. Checking her airway, Foreman notes that her breath smells fruity. Wilson recognizes diabetic ketoacidosis. Abigail’s pancreas is failing, as House had predicted. Grasping for answers, Cuddy orders an LP for lymphoma as well as an antibody test for lupus.
Cameron sneaks off to House’s apartment to talk about Abigail. When he opens the door, Cameron is shocked that he’s in such bad shape. Noticing a cut on his arm, she forces her way in. She cleans the cuts and sees that each is straight. House cut himself on purpose because it releases endorphins and endorphins relieve pain. House asks if Abigail has been sick lately, then suggests Still’s disease.
When Cameron returns to the hospital, Cuddy asks what House said. She is the one who sent Cameron to him. Her report of Still’s disease is disappointing because it is virtually unable to be confirmed. Cuddy asks how he is doing. When Cameron pointedly says they can trust his judgment, Cuddy orders the treatment.
House ambles into the hospital and asks Wilson for a prescription to help stop the vomiting from detox. Wilson advises him to go into rehab, where he can get the drug. House checks the case file that Wilson left behind, then barges into a room where Wilson is consoling an elderly widow whose husband just died. House makes a racket about being strung out and still able to come up with a better diagnosis than Wilson. The widow begs him to leave and he heads out. Wilson realizes that House could’ve made this scene anyway. He searches House’s pocket and finds a bottle of oxycodone that House stole from the dead man’s bedside. Wilson asks House if he’s sure that he doesn’t have a drug problem. In shame for once, House limps out.
Cuddy tells Wilson that Abigail is responding to treatment and that House’s diagnosis was correct. Wilson is despondent that he never even considered Still’s disease. Later, Wilson sees Tritter. He argues that drug addicts hurt people, but House saves lives and makes right decisions that nobody else could ever make. Wilson won’t testify against him. Tritter threatens that, based on previous statements, Wilson will be sent to jail. His refusal to testify won’t protect House, either.
Cameron is called to Abigail’s room when the girl starts bleeding from her mouth and ears. House heads to the hospital pharmacy to pick up a prescription. The pharmacist points out that it’s for Dr. Wilson. House claims he’s picking it up as a favor, badgering the pharmacist into handing over the pills. Drugs in hand, House retreats to a lonely stairwell and immediately pops some pills.
Abigail is on the verge of a multi-system failure and the doctors have no idea why. Cuddy tracks down House in the hospital cafeteria and tells him that the diagnosis was not Still’s disease. They are desperate for answers, so she offers him pills in exchange for a look at the case. Yet he is acting loopy enough to alert Cameron to the fact that he found some pills already. Ignoring Cuddy and talking to a young girl in the cafeteria, House has an epiphany. They need to x-ray Abigail’s leg.
The leg is more than fine. It has normal growth plates, which should be impossible in a dwarf. Wilson is still trying to figure out how House got his hands on more pills. Barreling ahead, House explains that they all assumed Abigail was a dwarf because her mother is one. Because Abigail doesn’t have the skeletal structure of a dwarf, she clearly has a growth problem caused by a pituitary issue. The only thing that connects pituitary problems with the lungs, liver and pancreas is Langerhans cell histiocytosis, which is a group of idiopathic disorders. The doctors’ hunches about cancer or autoimmune issues were both somewhat correct.
Popping a few more pills, House explains the issue to Abigail and her mother. With some chemotherapy, the removal of Abigail’s granuloma and a round of growth hormone pills, Abigail will begin to grow to a normal size.
That night is Christmas Eve. House sits at home, staring at a pill bottle. He picks up the phone and leaves a message to his parents, wishing them a Merry Christmas. Then he hangs up and downs more pills before chugging a glass of whiskey. On Christmas morning, Wilson comes by and finds House face down on the floor in a puddle of vomit. Next to him is the prescription bottle that House stole from the pharmacy. Wilson recognizes the name of his dead patient on the label of the empty bottle.
Later that afternoon, having scraped himself off the floor, House swings by Tritter’s office to take him up on his offer. Yet the deal is now off the table. Tritter has found some new evidence and no longer needs Wilson to bring down House. Tritter saw the pharmacy log and noticed that Wilson’s dead patient picked up his oxycodone. House realizes that he is in serious trouble.

House, MD Season 3 Episode 309: Finding Judas

A man named Rob doesn't understand why his daughter Alice is not interested in the rides at the carnival. On one ride, the little girl begins clutching her stomach and screaming in agony.
At the hospital, Rob argues with his ex-wife, Edie, about taking Alice on the ride. Cameron is more interested in Alice's medical history, which does not indicate any abdominal problems. Edie snipes that Rob only had Alice for two days and she ended up in the hospital.
House pulls Cuddy out of a meeting with two potential financial donors. He wants his pills. She walks over to the pharmacy, grabs a cup with two Vicodin in it and hands it to House. His days of free-flowing pills are over. No doctor in the hospital will make a move now that Tritter is watching them.
As the doctors mull over Alice's case, House barges into the office, heads straights to a textbook where he has hidden a bottle of pills cut inside the pages. House then takes a quick glance at Alice's CT scan and declares gallstones. Although six year-olds don't get them, they could be vanishing gallstones. He considers that Alice had one and it passed, but more are probably hiding in her gallbladder. House orders an ultrasound. If he's right, they can remove the gallbladder in order to biopsy the stones.
The team performs the ultrasound and they bicker over Chase's eagerness to adhere to House's instant diagnosis. Yet Alice does indeed have gallstones. Chase breaks the news to the parents, along with the plan to remove Alice's gallbladder for a biopsy. Rob quickly agrees to the procedure, but Edie doesn't.
Cuddy finds Tritter in an office poring over boxes of files. She accuses him of making this personal, and asks if he thinks Wilson deserves to have his life turned upside down. Tritter says this is how he gets what he wants. If squeezing Wilson doesn't work, it will eventually work on Foreman or her.
House berates Edie for refusing to consent to Alice's surgery. Edie stands her ground, pointing out that gallstones are basically harmless. House brings a judge into the hospital and attempts to bully the woman. The judge turns to Cuddy for her opinion on House. Cuddy agrees with the judge that House is indeed a jerk, but he does know what he's talking about. The judge orders the surgery.
The procedure goes well, but the biopsy is negative. Edie bitterly points out that her opinion about the surgery as unnecessary has been proven correct. Alice begins complaining that her stomach hurts, so Foreman takes a quick peek. He finds a blistering rash breaking out across her midsection.
The next day, House questions the team about the rash. His doctors are more concerned with why their bank accounts have been frozen. They demand that he talk to Tritter and do something about their money. House tries to get past this, and he instructs his team to do a scratch test on Alice for allergies, which is what Cameron suspects. When the allergy tests are negative, they are to start broad-spectrum antibiotics. House thinks it is a bacterial infection.
The scratch test gets many results. Each one has come back with a positive allergy result. Looking at Alice's back, House still rejects allergies and points to bacteria as the cause. He is sure that bacteria got into the scratches. Chase insists that infections radiate, which isn't what Alice's rash is doing.
House gives Alice of bite of the peanut butter sandwich he's holding. He then asks Foreman and Chase if Alice is allergic to everything except peanuts. Chase points out that if she is allergic, then antibiotics could cause a massive reaction. House again insists that she isn't allergic. Chase moves to grab the antibiotics, but Foreman stops him. He tells him that he is correct and should stand up to House for once. But before Chase can start an IV, Rob steps in and refuses to allow it.
The case is reverted again to the judge, and House argues against the father's decision. The judge becomes tired of House contrasting the parents on every decision and she grants temporary guardianship to Cuddy. Against using broad-spectrum antibiotics in the event that Alice is allergic, Cuddy decides to allow just one antibiotic -- metronidazole -- as a test.
Tritter interrogates Foreman and mentions Foreman's brother, Marcus, who is doing time on a drug charge. If Foreman testifies against House, Tritter will see to it that Marcus is free within two months. Foreman still doesn't budge. Tritter observes that Foreman is just as cold as House. Yet he is convinced Foreman will take this deal because he hates hypocrisy. House has had a thousand chances, and Foreman himself has had a couple. Marcus only got one chance.
Cuddy checks in on Alice, who sleeps peacefully. There doesn't seem to be any reaction to the metronidazole. The parents fight about Rob's decision to withhold antibiotics and Edie angrily declares that she's suing for full custody as soon as they get out of the hospital. Alice's heart starts racing and her blood pressure rises. Cuddy realizes that the parents' arguing is giving Alice an anxiety attack. She kicks them out of the room.
The next morning, Chase announces that Tritter froze his accounts as well. Edie comes into their office wondering where Alice and Rob are. Chase rushes off to get security and sees Rob holding an unconscious Alice in his arms. She's as stiff as a board.
House mocks Cuddy's decision to skip broad-spectrum antibiotics. Foreman injects Alice with diazepam to relax her and points out that muscle rigidity is almost exclusively neurological. Cameron guesses at neuroaxonal dystrophy. Ignoring the patient, House starts yelling at Cuddy to give him more pills. She refuses.
House accosts Rob and Edie about which one of them gave Alice an aspirin. He believes that Alice has Reye's syndrome. When a child with an infection takes adult aspirin, it affects the brain and liver. Neither of them did, but Edie says that a babysitter might have administered them the night before she came to the hospital. House orders Cuddy to put Alice on charcoal hemoperfusion, and then he demands more pills for himself. Cuddy pulls a bottle out of her pocket and taps two pills into House's palm.
Cameron gets her turn to sit down with Tritter. She refuses to participate, so Tritter brings up her past. She used to be somebody who always did the right thing until she starting working with House.
Chase meets with Tritter in the hospital cafeteria. Tritter explains that he's going to unfreeze Cameron and Foreman's accounts, but not Chase's. They both know that Chase's account never was frozen. Chase lied about that to the others so it wouldn't look like he had been singled out. Yet now that the accounts are open, people will notice the two of them having a very pleasant lunch in the cafeteria. House will eventually put two and two together.
Cuddy explains the procedure to Alice. The little girl admits that she is scared of her parents. As soon as she's better, her parents will split up again. As the procedure is underway, Alice starts screaming that her arm hurts. Foreman suspects it might be a clot, so Alice is rushed into surgery.
Foreman successfully removes the clot, but Alice's body temperature begins increasing. The O.R. is out of ice packs and cooling blankets, and they need to cool Alice down before her brain melts. Cuddy yanks the wires out of the monitors and takes Alice into her arms. She rushes the girl into a cold shower. Cuddy shows House the rash that has returned to Alice's arm. Increasingly tense over his pain and the Tritter debacle, House angrily declares that he was right about the broad-spectrum antibiotics. He then icily tells Cuddy it's a good thing she failed to become a mother because she sucks at it.
House launches into a differential diagnosis with the team. With the arm rash, they never treated Alice's arm. Yet now it is so intense that simple antibiotics won't work. The team has no answer. Cameron says that Tritter released their accounts. The team all suspects that somebody talked. Cameron finally throws out Rocky Mountain Spotted Fever and House orders doxycycline as a treatment.
The next morning, Foreman reports that the treatment didn't work. The rash is getting worse and spreading to her leg. House thinks that the infection has morphed and moved into Alice's muscle sheath. Foreman realizes that House is referring to necrotizing fasciitis, for which there is no cure. The only treatment is amputation. The team is loathe to amputate Alice's arm and leg with a confirmed diagnosis. House points out that they've waited too long and don't have time for a culture. If the rash spreads, Alice will die. The doctors continue to resist. House, in physical agony, snaps that just because Alice is cute doesn't mean she cannot have flesh-eating bacteria. Cute kids die and innocent doctors go to jail. He remarks that cowards like Chase, Foreman and Cameron won't stand up and do what's right.
House stomps into Cuddy's office looking for pills and the consent to amputate Alice's limbs. Cuddy and House break the news to Rob and Edie. They realize they have no other choice. Alice is sent into surgery. At the same time, the doctors sit in their office complaining about House. Cameron, still thinking about Alice, mentions the rashes. Perhaps Alice is allergic to surgical equipment. Chase, bored, begins shining a laser pointer on Foreman. Foreman complains that he's going to burn his retinas. Chase suddenly has an epiphany.
Chase races out to the lobby and finds House, shouting that he has to stop the surgery. Alice doesn't have necrotizing fasciitis. She has erythropoietic protoporphyria, which is a genetic condition that makes her allergic to light. Alice got worse every time she went under surgical lights. When Rob took her outside, she stiffened. House tells Chase to get out of his way. When he doesn't, House punches Chase in the face. Even House seems shocked by what he just did. Chase is still focused on Alice, and replies that light damages the blood cells. The damaged cells contain protoporphyrin build-up in the liver which shuts it down.
The call comes into the operating room as the scalpel moves toward Alice's shoulder. The surgeon stops just in time. Cuddy explains to Rob and Edie that Alice has always had this genetic condition, but it reaches critical mass around this age. Alice's life will be complicated but she'll live. When Rob and Edie ask how their daughter contracted the disease, Cuddy lies and says that both parents must be carriers to pass the disease along. She fears that another argument will break out.
That night, Chase finds Wilson in the doctors' lounge. He mentions that House screwed up Alice's case, but Wilson says that has happened before. Yet this time, when Chase told House what Alice's real condition was, House simply didn't care.
Wilson approaches Tritter and tells him he's going to need thirty pieces of silver.

House, MD Season 3 Episode 308: Whac-A-Mole

It's a children's birthday party at a family restaurant and arcade. A teenage waiter, Jack, rushes a birthday cake to a party, ignoring his younger sister, Kama, and her requests for more soda. The restaurant mascot comes out for the traditional birthday dance and Jack vomits all over the table in the middle of dancing. Then his heart stops.
Paramedics rush to the scene and try to shock Jack back to life. Standing with her younger brother, Will, Kama pleads with the paramedics to save their brother. The paramedics advise Kama to call their parents and Kama says that their parents died. Jack is all they have left.
Wilson emerges from his hotel in the morning to find that his car is being seized on Tritter's orders. At the hospital, the team reviews Jack's case with House. He had a heart attack, but an echo showed no abnormalities. Cameron reads from Jack's file: fatigue, night sweats and weight loss preceding heart attack. House wonders about the itchy feet also listed.
Ignoring his team, House writes his diagnosis on a piece of paper, seals it in an envelope and tapes it to the white board. He then announces a game to his team. They get one test each and the clock runs out at lunch. If House is right, Jack lives. If not, well, then it's a very cruel game.
The doctors study Jack's file, with Chase paying particular attention to the page House was on when he wrote down his diagnosis -- the patient history. When his parents died, Jack quit using drugs and quit smoking. Thinking bacterial, Chase plans to do a blood culture. Foreman's going for an MRI. Cameron is keeping her test a secret.
Chase is working on Jack when House strolls into the room. He asks Jack about his itchy feet before inquiring about the drug use. In front of his younger siblings, Jack admits to previous drug use, but says he's clean now. House thinks it's all lies.
Foreman slides Jack into an MRI. House, hovering in the control room, gets on the microphone and again presses Jack about his drug use. Then he asks how Jack managed to go from two packs of cigarettes a day to nothing just cold turkey. Foreman, finding this relevant, asks Jack to answer. Jack explains that he didn't really quit. He just sorta lost the taste for smoking. A smug House asks Foreman if he thinks that's an important bit of information.
Now it's Cameron's turn. She injects Jack with a substance to see if his heart attack was caused by a spasm in the vessels surrounding the heart. House, naturally, pops in on this test as well. House observes that Cameron's injection has had no effect.
Cuddy notices Wilson's late arrival. Wilson testily announces that his car is being held hostage until he rolls over on House for Tritter. Cuddy nervously points out that any conviction for House will cost the hospital. Wilson, still testy, tells her to relax before heading to the pharmacy to find out why all of his prescriptions have been bounced back recently. The pharmacist informs Wilson that his DEA number has been suspended. This is not good.
House confronts his team will the results of the tests. They all whiffed. But Jack did have positive titers for Hepatitis A. House wonders who ordered that particular test. It must've been somebody who knew what persistent vomiting, itchy feet and a sudden distaste for nicotine have in common. That somebody being House. Foreman points out that Hepatitis A doesn't explain the heart attack. But the puking does. And Hepatitis A explains the puking.
Wilson shuffles in with the news that the DEA revoked his prescription privileges. House tells him to relax. Tritter is just trying to squeeze him until he gives in. Wilson tells House he's going to use his team to do his prescribing until everything is straightened out. After ordering his team to start Jack on IVIG and handing his diagnosis envelope to Cameron, House follows Wilson out of the office. Cameron opens and reads what's inside. The note predicts that Chase would do a blood test for bacteria, Foreman would do an MRI and be too stubborn to check the lungs and Cameron would look for a spasm.
The next day, Foreman ambles in to Jack's room with good news. The Hepatitis A has cleared his system so they can unhook the IV and Jack can go home tomorrow. Will asks Jack if his arm hurts and Jack says it doesn't. Will asks why it's bleeding and when Jack holds his arm aloft, blood is pouring down his foreman from the IV connection. Then blood begins to trickle from his ear and nose.
Later, Foreman informs House that a high PT and PTT on Jack's blood panel have confirmed a coagulopathy. House finds it interesting that after they cured the Hepatitis A, something new popped up. He asks what infections cause DIC. Cameron mentions that kids don't wash their hands after using the bathroom. Jack's place of employment is probably teeming with E. Coli, Eikenella and strep. Chase thinks about a food-borne toxin. House orders Foreman to give Jack an LP, Chase to sample some of Jack's vomit from the restaurant and to have Cameron check the place for the diseases she mentioned.
After the meeting breaks up, House pulls Chase aside and asks for a prescription for Vicodin. When Chase resists, House makes it an order. But Chase declines, saying he'd rather lose his job than his medical license.
Wilson has pulled Cameron into his office and is running down his patients and the drugs they need. Cameron balks, saying that she'll need to examine the patients before putting her name on any prescriptions. Especially with Tritter watching them.
Behind the restaurant, Chase goes through the dumpsters with one of Jack's co-workers. The guy explains that they don't use any toxic cleaning products since kids put everything in their mouths, then directs Chase to the bin holding the trash from Jack's last day there.
Foreman performs the LP on Jack. After the procedure is completed, Foreman puts his hands on Jack's side to roll him over. One of Jack's ribs snaps and he screams out in pain. When Foreman informs House of this, and explains that he barely put any pressure on Jack, House recognizes osteomyelitis. The infection has spread to Jack's bones.
House, whose pain has been increasing without his Vicodin, has been given a new cane by the hospital physical therapy. A four-pronged metal job. The doctors are quick to mock it when House tracks them down in the lab. Foreman breaks the news about osteomyelitis to his colleagues. Jack has syphilis. But Cameron's blood test shows that he's also positive for Eikenella. As the doctors try to process this, Chase announces that his test for botulism has also come back positive.
The next morning, Foreman informs House that they managed to clear all three infections from Jack's system, but now he's having seizures every few hours. House figures he must be immuno-compromised. But his blood work was negative for HIV and lymphoma. House goes back to drug use. Despite the clean tox screen, perhaps some drugs were trapped in Jack's fat cells. With his vomiting and rapid weight loss, perhaps they've come out to play. If they can make Jack lose more weight, maybe they can trigger another attack.
The doctors sit in the hospital sauna with Jack. He insists that he's off drugs. He was high the night the cops told him about his parents and the first thing he did was laugh. That was enough to clean him up. Jack then falls to the floor and has another seizure. Foreman reports back to House that Jack was completely drug-free at the time of the seizure, and he's still having them every few hours whether he's in a sauna or not. House, figuring that something besides infection is causing the seizures, orders another brain scan.
Foreman gives Jack another MRI. His brain stem is clean. So is the midbrain. But when they cut to an axial view, they realize that Jack's brain is now riddled with tumors. The doctors press House to start radiation treatment, but House has two concerns. First, the radiation would destroy the little immune system Jack has remaining. Second, he finds it hard to believe several tumors just suddenly appeared from nowhere. Maybe it's fungus. He instructs the team to stick a needle in Jack's brain and make an extraction. If it's liquid, he's right. Solid, they're right. With that, House pops his last remaining Vicodin and angrily tosses the empty bottle in the trash.
House barges into Cuddy's office and asks for a Vicodin prescription. Cuddy smiles, knowing if House is approaching her, his staff stood up to his bullying. Cuddy pulls out her pad and writes a scrip, acknowledging that if she cuts him off, the police will assume House doesn't really need the meds. But before she hands over the paper, Cuddy notices House massaging his aching shoulder. That's a change. She asks him what's changed in his life recently. House stops. He's on the verge of an epiphany.
Foreman returns from the brain surgery on Jack. The marks on the MRI were abscesses from a fungal infection. Aspergillis. Thinking that his parents' death could be enough of a trauma to trigger Jack's genetic illness, House begins running down everything that's gone wrong. He decides that they need to introduce new infections and see what happens.
House informs Jack that each of the four possible genetic conditions is most susceptible to a different type of infection. House pulls out a spray bottle from his pocket. Inside is a cocktail of serratia, meningococcis, cepacia and rhinovirus. Whichever germ strikes first will give them their answer. If it's meningococcis, Jack will have another seizure. Serratia will shut down his lungs. Cepacia means a heart attack and rhinovirus means... he'll sneeze. House spritzes Jack's face.
The doctors begin shifts at Jack's bedside. Hours later, his lungs begin to shut down. Serratia wins. The next morning, House pronounces it Chronic Granulomatosis Disease. Jack needs a bone marrow transplant to reboot his immune system. Fortunately, Will is a match. But when Foreman explains the situation to Jack, he's angry that the doctors pressured his younger brother. Foreman tries to persuade Jack to consent to the transplant, explaining that Jack will constantly get sick from the germs he'll contact every day. He'll constantly be in and out of the hospital. Jack agrees to the procedure, but not until Will is 18 and can decide for himself.
House scoffs at Jack's decision. He thinks he's running from something. House brings Foreman back into Jack's room and tells Jack they found a bone marrow match in the registry. No Will, so they can proceed. Jack counters that he could die, but House sees through this. He keeps pushing Jack until he breaks down and admits that he's too young to be a father to Kama and Will. Having proven his point, House leaves Foreman and Jack alone in the room.
That night, House finds Wilson in his office. Wilson announces that he's shutting down his practice and referring his patients to other oncologists. House chides him for overreacting and Wilson erupts, screaming that he can't put his patients on hold while waiting for House to release Cameron from her duty to sign prescriptions. House sarcastically asks if he should turn himself in and Wilson snaps that that's exactly what he should do. Show Tritter some remorse. Promise to get help. House bristles that he doesn't need any help. Wilson tells him to get out.
Elsewhere, a social worker stands in Jack's room with Kama and Will. Jack tries to sell them on the orphanage and promises that he'll still be able to see them. Foreman is crushed as he observes this moment from the hallway.

House, MD Season 3 Episode 307: Son Of Coma Guy

Seeking solitude, House eats lunch in the room of vegetative patient Gabe. Wilson is all riled up about his encounter with Tritter and comes to find him. House is more concerned that their stories jibe with each other. Gabe’s son Kyle enters the room and is surprised to see two doctors eating lunch in his father’s room.
House tosses a bag of chips at Kyle, but it hits him in the chest and falls to the ground. House stands up and moves to the side, disappearing from Kyle’s view. When he pops up in front of him, the boy is rattled. House explains that he has observed Kyle in the past and thinks he has akinetopsia. He can’t see things when they’re moving. This affliction is accompanied by seizures. Kyle collapses and begins seizing.
Chase and Cameron later examine Kyle. She asks about his family history. Kyle says that his father didn’t like his mother’s family. Now that his mother is dead, Kyle would not know how to contact them. His father Gabe is an only child of dead parents. Chase discovers Kyle’s backpack is full wine bottles.
Kyle claims that his past CT scans have been clean. House studies Gabe’s EEG. Both father and son show cortical seizures. House asks for a DNA test and a check of the home. Foreman and Cameron work in the lab when Chase returns from the home check. All he found was a single bed and some condoms.
The boy’s adrenomyeloneuropathy test comes up negative. House asks for more DNA tests, this time for Ubverricht-Lundborg and late-onset Lafora’s. He’s determined to find a hereditary link. Foreman and Cameron spend some more time with Kyle, inquiring about his lifestyle. He says he is a loner who works from home. No one ever comes over except for an occasional pizza delivery guy. Kyle says he sees his father in the hospital more than anyone else. Cameron notices bruising and puffiness around Kyle’s stomach and she suspects his liver is failing. Kyle begins coughing up blood.
The team reports back to House that Kyle is now unconscious and is heading for a coma. He orders them to stop all treatments because, if Kyle’s liver was in bad shape to begin with, their anti-seizure drugs may have pushed the damage over the edge. Foreman puts Kyle on dialysis. House thinks they need a better history on Kyle before they can proceed.
House leads his team to the hospital pharmacy and grabs a vial of L-dopa. The doctors can’t believe that House is planning to revive Gabe out of his vegetative state. House is about to inject his drug cocktail into Gabe’s IV when Cuddy barges in, demanding that he stop. House goes ahead and injects it anyway. Gabe immediately sits up in bed and asks for a steak.
After examining Gabe’s senses and faculties, Cuddy is amazed that he is remarkably alert. He denies a family history of seizures on either side, but asks how long he has been in the hospital. House is intrigued that Gabe’s internal clock seems to have kept ticking for the ten years he has been under.
On his way to the cafeteria to get Gabe’s steak, House is intercepted by Wilson who asks if he really brought a patient out of a ten-year vegetative state. House happily admits to being the culprit. Yet the most curious part of Gabe’s first conversation is that he didn’t show any emotion when he learned about his son Kyle’s condition. Wilson considers whether it is a brain issue, but House wonders if Gabe simply doesn’t like his son.
Tritter approaches Cameron to interrogate her. Cameron defends House, but is stopped when Tritter notes that House left Wilson holding the bag. She was not aware of this, and Tritter uses that fact to dig more. Cameron’s pager goes off and she has to rush out. Yet she was summoned by Chase and Foreman, who want to know what she said to Tritter. House busts in to inquire about Kyle, who has been taken off all drugs except for antibiotics. While his liver is just holding on, he is still sliding toward a coma.
Cuddy gives Gabe normal clothes and has told him that he will once again become a vegetable when the drugs wear off. House presses him about Kyle, but Gabe expresses amazement that House wasn’t going to tell him the drugs would wear off. Gabe is adamant that he will not waste his time in a hospital if he only has one more day awake. He wants to get a hoagie at this place he knows in Atlantic City.
House asks Wilson to borrow his car and some money because he has to take Gabe to Atlantic City in exchange for information about Kyle. Worried about what might happen to his nice car, Wilson tags along. Gabe drives. They stop at a convenience store for snacks and Gabe mentions that he’s allergic to berries. House quizzes him about where he used to live and where he might have visited. Gabe introduces a new rule to their trip: for every question that he answers, House has to respond to one of his questions.
Back in Princeton, the doctors examine Kyle and discuss Tritter’s quest. Cameron seems skeptical that House would steal Wilson’s pad to forge prescriptions because he would never put a friend at risk. Foreman, still surprised by Cameron’s naïveté, says that a junkie will do whatever he has to do to get what he needs.
On the road, House and Gabe exchange rapid-fire questions. Gabe wants to know about House’s past loves. House inquires about the business and factory Gabe used to own. House admits that he has been in love with a lawyer. Gabe explains that he owned a business making luxury boats comprised of large hulls with parquet floors. Kyle used to run around the factory floor as a boy. House thinks he has his answer. Mercury in the spray paint that the company used affected Kyle’s central nervous system, which explains the seizures. Furthermore, the liver would strain the mercury from the blood. When Kyle damaged his liver with heavy wine consumption, the mercury started running through the body again.
House calls the hospital and instructs the team to test Kyle’s blood for mercury poisoning. They should start heavy metal chelation while waiting for the results. At the same time, Tritter grills Chase about a past prescription that Chase wrote for House. Tritter thinks Chase was ordered to do it and is now left lying to the police.
The road trip arrives in Atlantic City, but the sandwich shop that Gabe was looking for is no longer there. Wilson suggests that they head back to the hospital so that Gabe can spend some time with his son before he lapses. Gabe is more interested in the hoagie. Wilson asks him why he dislikes his own son. Gabe gets frustrated and demands to be checked into a hotel with a casino.
House starts up the question game with Gabe, and Wilson chimes in with his own inquiry. Why did House steal his prescription pad and not some other doctor’s? Wilson knows it is because House always has to push friendly relationships as far as he can. Then when they break, he can claim all relationships are conditional. This allows him to isolate himself from people.
House gets a call from Foreman. Kyle’s blood pressure is plummeting and the mercury test results were negative. This is bad news. House asks for an echo test. When he hangs up, House demands to know from Gabe how every relative had died. As they run through the family tree, Gabe asks Wilson to toss him a soda. Gabe doesn’t catch it. It bounces off of him and falls to floor, which is the same thing that happened with Kyle earlier. Gabe’s drugs are wearing off.
Back at the hospital, Tritter approaches Foreman for a chat. Foreman makes it clear that he thinks House is an ass, but he also thinks the man is truly in pain. He doesn’t believe the government should be deciding what number of pills will ease that pain. Tritter responds that the one thing he’s learned as a cop is that everybody lies. This gives Foreman pause.
In Atlantic City, Gabe questions why House became a doctor when he hates people so much. House tells the story of being a 14-year old in Japan. A schoolmate got injured while they were rock climbing and House brought him to the hospital. They passed a janitor as they entered. The friend developed an infection and the doctors didn’t know what to do. They brought in the janitor, who was both a doctor and a buraku, which is one of Japan’s untouchables whose ancestors were slaughterers and gravediggers. Because this man was usually right about patients, they had to listen to him even if they never wanted to deal with him.
Gabe recalls the night when his house burned down and his wife was killed. Kyle had been popping corn in the fireplace and dislodged some tinder. The fire spread quickly. When Wilson calls Gabe a disappointment, he reacts angrily. Jumping from the chair, he yells that he couldn’t save his wife and now he cannot even save his son.
House thinks about young Kyle had complained that the popcorn tray was too heavy. He asks about two other relatives who died in accidents and learns that both occurred at night. House has his answer -- ragged red fiber, which is an inherited condition that leads to muscle weakness and poor night vision. Although people seem clumsy and careless, it is not that simple. Kyle’s liver was only hampered by the excessive drinking due to depression. House calls Foreman and instructs him to run a DNA test for ragged red fiber. Yet he learns that Kyle has severe cardiomyopathy. He’s going to die no matter what.
House breaks the news to Gabe. After a period of long, silent thinking, Gabe announces that he wants to give Kyle his heart. Wilson tries to talk him out of it because they may one day cure his vegetative condition, but Gabe is convinced. Cuddy refuses to allow this too. House tells Wilson to leave the room. He presents Gabe with some options. Pills are the easiest, but hanging has less chance of damaging the heart.
Since they won’t get back to Princeton in time, Gabe opts for strangulation. Wilson clumsily hits on married woman in the casino. He asks her if she likes to swing, then conspicuously approaches a House look-alike about joining in. The woman takes note of them both and walks away. This helps them have an alibi while Gabe is killing himself.
House and Wilson sit in the hallway and hear a thud from inside the room. Wilson arranges a helicopter to quickly fly Gabe to Princeton. Kyle and his father’s body are wheeled into surgery, and the heart transplant is a success.
House finds Wilson trying to get money from the ATM, but there is a problem. Wilson calls his bank and learns that his funds have been frozen as part of a police investigation. House assures him that they can’t keep his money forever. Wilson knows that they will keep his money until he agrees to give up House.

House, MD Season 3 Episode 306: Que Sera Sera

Firefighters are called to the residence of George Hagel, a 600-pound man who has died. As a team of firefighters tries to lift George’s body, somebody in the room passes gas. That somebody is George. The chief checks and finds that George still has a pulse.
Cuddy brings George’s file to Chase, Foreman and Cameron. House isn’t in yet. Cuddy informs the doctors that George is in a coma, but his blood sugar is normal, his cholesterol is lower than hers, his tox screen was clean and there’s no sign of trauma. The team is astonished by this news. Cuddy wonders where House is.
Well, he’s in a holding cell at the police station. Frustrated, he tells Tritter to let him go. Tritter suggests arraigning him instead. Finally, Wilson appears and posts House’s bail. House meets Wilson outside and Wilson immediately hands him a bottle of pills. House assures Wilson that he’s innocent and Tritter just wanted to punish him.
The doctors are mulling over George’s case and House’s whereabouts when House suddenly pops into the office. House quickly orders the team to start treating George for Pickwickian Syndrome. Foreman counters that George’s CO2 and oxygen stats are normal, but House points out that they’re only normal for an average-sized person. House also wants a detailed medical history. Search his house and talk to his neighbors if you need.
George’s neighbor, Sophie, allows Cameron into George’s apartment. She surprised by how tidy and orderly the place. The place also has a high-end kitchen, including a wine cellar. Sophie informs Cameron that George loves cooking and frequently prepares four-course gourmet meals for himself. He also has prostitutes visit on occasion.
House is working clinic duty when he spots Tritter in the lobby. Tritter says he was merely bringing Cuddy up to speed on the arrest. Conspicuously popping a pill before Tritter, House advises him to quit while he’s ahead. Tritter eyes up House, then leaves. Foreman and Cameron approach with the information that intubation and steroids have had no effect on George. Thus, they’re ruling out Pickwick’s. House suggests blood clots in the brain and orders either an MRI or a CT scan. Problem is, those machines have weight limits well under what George weighs. House suggests that they just start treatment then.
Knowing that blind treatment could possibly kill George, the team tries to MRI him. Cameron thinks it’ll work if they just get his head inside the machine, but Foreman worries that George will break the table, ruining a million-dollar machine. Adamant that George deserves the same standard of care as anybody else, Cameron assembles a team of nurses to hoist George onto the table. Incidentally, she lies about George’s weight to get them to help.
Cuddy finds House in his office and hands him contact information for the best defense lawyer in the county. The moment she leaves, House crumbles the paper and throws it out. Elsewhere, the doctors find nothing out of the ordinary on George’s MRI. As they begin to weigh their options, George comes to life and starts screaming. As Foreman and Chase struggle to pull him out, the MRI bed breaks with a loud crack.
House and the team reconvene to discuss what they know. They don’t know much. A calm, but angry, Cuddy enters asking about the machine. House blames his staff for disobeying his orders to start treatment. Cuddy isn’t buying it, but Cameron pipes up and admits what happened. Foreman wonders about hormones. Acute adrenal insufficiency could possibly cause a coma. He wants to do an ACTH stimulation test and check George’s skin for acanthosis nigricans. Cameron, focusing on the prostitutes, wants to run a full STD check. Chase suggests doing nothing, and if George doesn’t get worse, figure it was a hematoma that dissipated. House considers, then decide to go with all of the theories.
Foreman and Cameron begin their tests on George, who insists he’s fine. Every doctor he’s ever seen has checked his hormones, then his blood pressure. And the results are always the same. He asks the doctors when he can leave the hospital. Foreman and Cameron finish the tests, then report back to House that the skin exam and ACTH stimulation were normal, and the blood and urine were negative for chlamydia, herpes and syphilis. House is intrigued by the mystery, but Foreman then reports that George is asking to be discharged.
House shuffles over to George’s room, where he finds him eating dinner. House tells George that he awoke from a coma caused by an unknown condition and wanted to leave the hospital. So either George isn’t in his right mind or he knows what the condition is. House guesses at various conditions, but George angrily insists that he doesn’t know what’s wrong. He’s not depressed, he just doesn’t want to stay there. House gets a cell phone call and leaves.
The call was about House’s apartment, which has been ransacked. As he looks around, he sees Tritter in his hallway with two uniformed officers. Tritter coolly informs House that they’re executing a search warrant. Tritter holds up an evidence bag full of pills and estimates that it must hold over six hundred Vicodin. Most DAs would say that shows intent to traffic. House scoffs, pointing out that each pill is held in a prescription bottle. Tritter agrees, but theorizes that if House is so unprofessional and unethical, maybe it’s possible that some of those bottles are in other’s names. Or came from forged prescriptions. Or simply stolen. But House has nothing to worry about, right?
The next morning, House instructs his team to send George home. Cameron resists, but House is more interested in tracking down Wilson and finding out what he told Tritter. Wilson assures House that he merely told Tritter he prescribed the Vicodin.
As George is wheeled out of the hospital, Cameron makes a last gasp attempt to convince him to stay. George explains that he simply loves food. Whatever is going to happen, will happen. George stands from his wheelchair and prepares to walk out of the hospital as Cameron begs him to sit. George takes a few unsure steps and then collapses through a plate glass wall.
Foreman, Cameron and House gather. Foreman explains that disorientation and loss of balance could mean a neurofibromatosis. House mentions that that’s inherited, claiming one of his diagnoses was correct. Cameron argues that the disorientation isn’t a key symptom. And she would know because…she gave George three grams of phenytoin. She didn’t think he should be discharged and knew that would force him to stay.
Looking at the discharge report, House notices that George didn’t eat his breakfast, which seems odds for him. Coma, fever and loss of appetite stem from Chagas. Cameron is doubtful, as George hasn’t been out of the country before. House points out that his food has. House wants a sample of George’s CNS to determine which bugs are in his brain. But since George is too big for an LP, they’ll have to drill into his head. After some badgering from Cameron, George agrees to the test.
During the test, Foreman prods George’s brain and George begins screaming that he can’t see. The nurses struggle to hold him down. After the procedure, Foreman and Cameron inform House that there’s no inflammation in the optic nerve and the retina is intact. There was also no sign of Chagas. House wonders if they missed a tumor in the MRI. Or perhaps it’s diabetes, as evidence by the blindness and coma. He wants them to test George once more.
Cameron tries to give George some glucose water to drink, but he angrily slaps it away. They argue until George says that he’s been fat all his life, but sick only recently. If she wants to look for a disease that has nothing to do with his size, he’ll help them. Otherwise, leave him alone.
House meets with his new lawyer, Howard Gemeiner. Howard advise a plea bargain, which House has no interest in. So Howard quotes House his exorbitant fees, which House reluctantly accepts. When House returns to the hospital. Cameron asks how things went with the lawyer. House is disappointed that his secret is out. Moving on, Foreman says tests for MS were negative and Cameron says tests for diabetes were unperformed.
House barges into George’s room and accosts him about the diabetes test. House tries to forces the glucose drink on George, who strenuously resists. As they struggle, House notices George’s fingers. He limps out of the room. Cameron and Foreman follow. House orders x-rays of George’s hands and feet. Then a bronchial test, a sputum cytology and a CSF check for anti-hu antibodies. House thinks George has lung cancer. When the doctors are skeptical, House asks if they’ve felt George’s fingers. His hands are clubbed.
They take x-rays and are stunned when they realize House was right. George has ossifying periostitis on the ends of his fingers. After the tests are analyzed, Cameron enters George’s room to tell him they’ve confirmed small cell lung carcinoma. That caused a paraneoplastic neurologic syndrome, which in turn caused the coma and blindness. It’s inoperable, but radiation treatment is available. However, that will only buy him a few months. A year at the most.
In Wilson’s hotel room that night, Tritter is asking Wilson if he really wrote all of those prescriptions for House. Wilson admits that House can difficult, but he truly is in pain and needs that medicine, which is why Wilson prescribed it. Tritter pulls out a few scrips and shows them to Wilson. He points out that the signatures on some of them look different from others. Tritter notes that Wilson looks surprised. Covering, Wilson says that sometimes he gets bored and signs his name differently. Tritter tells Wilson he’ll give a second to reconsider his answer. Because if he’s lying, they’ll find out. Wilson sticks to his story. Tritter thanks him and leaves.

House, MD Season 3 Episode 305: Fools For Love

A young, interracial couple is among the hostage victims of a diner robbery. Jeremy bludgeons one robber’s head with a napkin dispenser and smashes the other’s head into the floor. His wife Tracy gasps for air. Her throat is swelling shut.
At the hospital, Cameron notes that the woman has Anaphylaxsis-like throat swelling. House is more interested in the fact that Jeremy and Tracy got married at age twenty. Cameron reports that the woman is not suffering an allergic reaction, but House is again distracted by Wilson chatting animatedly with an attractive new nurse.
House summons a laparotomy for the patient, but one was already performed and it was clean. Noticing marijuana in Tracy’s tox screen, Chase theorizes about salmonella from the pot. Foreman calls it a stretch. Without a better idea, House goes ahead and orders floroquinolone for the salmonella.
House attends to clinic rounds and encounters a patient named Michael Tritter who has a rash on his genitals. House quickly writes off the dryness as being a symptom of Tritter’s nicotine gum. Tritter asks for a swab to be tested, but House moves on. As House goes to leave the exam room, Tritter kicks out the cane and House trips. Tritter coldly mentions that when you treat people like a jerk, you get treated like a jerk in return. House agrees to take a swab and has Tritter bend over with his pants down. Yet House inserts a thermometer in Tritter’s rectum, claiming that he’s checking for fever. House walks out, leaving Tritter standing prone in the room.
Foreman visits Tracy to administer the floroquinolone. He inquires about the couple’s drug use and is met with hostility from Jeremy. Tracy starts to have an allergic reaction to the antibiotics. Foreman relays this information to House, who realizes that the salmonella was a stretch as Foreman had predicted. House changes his thinking to exercise-based anaphylaxis, figuring that adrenaline from the robbery pushed Tracy’s heart rate to the limit.
House puts Tracy on a treadmill to re-enact the stress level of the robbery. Seeing his wife struggling, Jeremy begins to get irritated and jumpy. He clutches his stomach and chest in pain. Jeremy is put in a hospital bed next to Tracy.
Talking through the case, House leads his team into the locker room and breaks into the new nurse’s locker, looking for evidence of a relationship with Wilson. He finds a flyer for a jazz festival, but nothing else related to music. Foreman thinks this is ridiculous. House bets him $100 that the nurse is dating Wilson. Much more interested in their latest case, Cameron points out that Jeremy and Tracy either caught the disease from each other or they were subjected to it in the same place. House orders an environmental check.
While searching the couple’s tiny studio apartment, Chase finds a box of condoms in Jeremy’s jacket. Foreman, knowing what House’s reaction will be, wants to ignore it. Chase insists on bringing it back to the hospital. House calls for a genital swab on each patient. Tracy reveals that she already knows about the condoms. They had a recent pregnancy scare and were being extra cautious.
Although the STD tests are clean, Tracy’s abdominal pain is getting worse. House orders her removed from the steroids. If she gets a fever, then it is an infection. If not, the problem is environmental. Tracy hallucinates that Jeremy’s father is in their room demanding that his son leave her. She screams and Foreman rushes into the room. He can see in her eye that fluid is leaking from the blood vessels in her brain, causing tissue to swell. Tracy lapses into a coma.
The team examines Tracy’s MRI and notice aberrations all over her brain stem. Comparing this to Jeremy’s chest x-ray, House wonders about sarcoidosis. The team is unconvinced, so House decides to consult Wilson, a sarcoidosis specialist. Wilson disagrees with House’s assessment, but House reports back to the team that Wilson said it was sarcoidosis. He orders methotrexate as treatment and a biopsy to be sure of his theory. This stops the team. They know a biopsy on the brain stem is likely to cause brain damage. House is ready to press ahead.
Cameron informs Cuddy about what’s happening. She refuses to let House near Jeremy because he will walk all over him. House asks whether Wilson can perform the biopsy on his behalf and Cuddy agrees. Wilson presents the options to Jeremy, but Jeremy would rather have the procedure performed on him instead since they share the same disease. Wilson points out that Tracy could die before his symptoms present. Jeremy won’t change his mind. He asks them to stop treating him so that his symptoms come out.
House is frustrated and hides in an empty patient room. The doctors follow, nervous about what he’s up to. House wants to inject Jeremy with naloxone in order to subject him to intense pain so that he will relent on the biopsy. The team wants to stop him and he reluctantly hands over the vial. After House leaves, the doctors realize he handed them a different vial. Foreman rushes to Jeremy’s room and finds House injecting the naloxone. Jeremy writhes in pain. House badgers Jeremy to consent to the test on Tracy, but he still refuses. The pain only seems to strengthen his resolve because he thinks his symptoms are getting worse and now he is closer to his own biopsy.
Cuddy pulls House into her office where Michael Tritter is waiting for him. Tritter wants an apology, although he’s really looking for humiliation. He wants House to think twice about his actions in the future. House refuses.
Jeremy’s state has become worse. However, it’s not in his brain and he doesn’t have sarcoidosis. His intestines are rotting. Both Jeremy’s and Tracy’s conditions continue to deteriorate. Chase figures Jeremy for ischemic bowel, which means they’ll need to remove a few feet of intestine. Foreman thinks that Jeremy likely has small cell vasculitis and Tracy has porphyria, which means their diseases may not be environmental or infectious. It may just be a coincidence. House orders hematin to treat Tracy’s porphyria and the removal of Jeremy’s dead bowel for a biopsy.
Foreman makes a shocking discovery in the biopsy. Jeremy’s bowel isn’t dead. The elevated lactic acid levels in Jeremy’s stomach leave no other option. But when House looks at the microscope himself, he realizes that Foreman is correct. The bowel is basically fine. House asks the team to go back to the very beginning of their diagnostic process. Jeremy and Tracy grew up next door to each other and ran off to get married after Jeremy’s racist, drug-addled father beat him up. House wonders whether it was really racism over Tracy’s color or whether Jeremy’s dad just didn’t like this particular girl. House thinks about Tracy’s eyes. They’re green.
House realizes that each of the patients has hereditary angioedema. Defective DNA is keeping them from making a critical protein. Jeremy’s father must have had an affair with the neighbor that produced Tracy. House orders his team to start treating them for the disease. This brings Tracy out of her coma.
After House’s hunch pays off, he wonders who will tell the couple the truth. Foreman thinks they should alert them to the genetic disease but keep their lineage a secret. House wants him to inform the patients or else he will do it himself.
Foreman prescribes Tracy and Jeremy daily pills which will stabilize them because angioedema is treatable. They ask Foreman how they both caught the disease, and he is forced to tell them that it is genetic. Neither of them catches on, so he explains that the hospital has concluded that they have the same father. Tracy gets sick to her stomach. She is lighter-skinned than her parents and people always mention that she and Jeremy have the same eyes.
Later that night, Chase asks Foreman to cover for a few hours over the weekend. Foreman replies that he is going out of town. House realizes that Foreman is the one dating the new nurse. House grumbles that it isn’t fair to bet when you already know the outcome, but he still forks over the money.
House speeds home on his motorcycle that night and he’s pulled over by police officer Michael Tritter. House scoffs at the idea of a ticket. Tritter, however, noted that he witnessed House pop a pill while examining him earlier in the day. Tritter deems House belligerent and under the influence of a narcotic. He reaches into House’s jacket and pulls out of handful of Vicodin. Tritter asks to see a prescription for the drug. When House doesn’t produce one, Tritter arrests him for possession.

House, MD Season 3 Episode 304: Lines In The Sand

A man named Dominic tries to teach his severely autistic son, Adam, to identify shapes and words. Adam doesn’t speak and does not have much success identifying the images. Adam begins clutching his chest and screaming frantically.
House is curious about Adam’s case. He finds it interesting that, in the ten years of closely caring for their boy who screams frequently, this is the first time the parents have admitted him to the hospital. Foreman and the other doctors simply dismiss the case, citing Adam’s severe affliction and his parents’ natural overprotective nature. House orders a stool sample to check for parasites, a blood culture to rule out infection and an ANA for lupus.
House barges into Cuddy’s office and demands his old, bloodstained carpet which she had replaced. She turns him down. House refuses to use his office.
Foreman and Cameron strap a struggling Adam into a scanner for his first test. The ventilation scan is normal so Adam can be sent home. Yet House wants a fecal smear test. The boys parents tell Foreman that they may have overreacted. Adam begins to gag and cough before spraying mucus out of his mouth. Foreman is now convinced that something is wrong.
Avoiding his own office, House convenes a team meeting in Wilson’s office. He orders an echocardiogram and antibiotics if the fluid returns. Adam screams maniacally as Foreman tries to administer the echo. The echo and an EKG confirm a conduction abnormality. Chase, thinking about the effusion, suggests they look for something that explains both the heart and lung problems. House wonders if cancer is present and he calls for a lung biopsy.
Foreman approaches Wilson about Adam’s case. There is pleural effusion and conduction abnormality, but an absence of heart failure. He asks Wilson the oncologist if they should perform a lymph node biopsy, and Wilson agrees. During the biopsy, Adam screams once again and the doctors aren’t able to hold a gas mask over his face for anesthetization. House comes in and takes a few breaths from the mask himself. This makes Adam accept the mask. He slowly falls under. His parents think it’s a miracle that their boy finally had some kind of conversation with somebody. House dismisses it as simple copycat behavior.
Wilson studies the biopsy. He doesn’t find cancer, but he does make an astonishing discovery. The cells under Adam’s arm are liver cells. The team meets once again in Wilson’s office to figure out a possible explanation. House focuses on liver damage, specifically cirrhosis. The team refutes because the echo showed no scarring on the liver and other tests were negative. House theorizes that damaged liver cells -- like cancer cells -- could work their way into the bloodstream and move north. He suggests that perhaps the parents who have been devastated by such a difficult child might have slipped something to him. House wants a liver biopsy to confirm cirrhosis.
Tired of finding House in his office, Wilson corners Cuddy and begs her to put the dirty carpet back. When she refuses, House camps out in her office to discuss Adam’s stool sample with Foreman. It had traces of iron, zinc and calcium carbonate. House is intrigued by the carbonate, which is an anti-diarrheal.
Adam is rushed to the cardiac ICU where he must be shocked back to life. His liver is damaged, his heart has abnormal pathways and pleural effusion has compromised his lung function. Yet the biopsy was negative for cirrhosis. House still suspects the parents but notes that Adam has pica, which means he will eat anything put in front of him. House asks Foreman to inspect the home for matches, spiders, mortar and anything suspicious that Adam would put in his mouth.
After a thorough search of the home, Foreman informs House that he found a small patch of Jimson Weed in the backyard. Jimson Weed contains atropine, which is the poor man’s acid. It explains the pleural effusion and the arrhythmias. Yet the treatment for that is physostigmine, which doesn’t mix with heart issues. They need to be sure before proceeding.
House shows Adam a picture of Jimson Weed and asks if he ate it. Adam instead points to a picture of his sandbox and then his eyes roll back into his head. House presents the new symptom to his team. Foreman wonders if there are tumors, but the team is skeptical that they would have missed that. Foreman plans on performing a CT scan. If that doesn’t work, he’ll remove the eye.
House sits in Adam’s empty hospital room, thinking. When he sees the picture of the sandbox and a chalkboard with wavy lines, something hits him. He rushes to the prep room and calls of Foreman’s surgery. House has them darken the room so that he can examine Adam’s eyes with a light. Since Adam can’t speak normally, he drew squiggly lines over and over again to explain what he was seeing. Worms swimming in his eye. A raccoon used Adam’s sandbox for litter and Adam ate what it left behind. The worms spread from his stomach to the rest of his body into the liver, the lungs and the eye. Laser photocoagulation will fix the eye, and a high dose of benzimidazole will kill the worms.
Wilson enters Cuddy’s office with a medical textbook. “Asperger’s Syndrome is a mild and rare form of Autism. It is typically characterized by difficulty establishing friendships and playing with peers, trouble accepting conventional social rules and they dislike any change in setting or routine,” he reads. Cuddy scoffs at the notion that House has Asperger’s, but Wilson mentions the fuss over the change in carpet. He theorizes that House took Adam’s case because he saw himself in the boy.
Wilson later finds House in the hallway and tells him that he knows he doesn’t suffer from Asperger’s. He wishes he did because it would free him from any social responsibility. Instead, he has to face the fact that he’s simply a jerk. Adam and his parents are leaving the hospital, and Adam stops to give his cherished PSP to House. Adam looks straight at House, making eye contact for the first time in his life.
That night, House watches as a carpenter unrolls his old bloody carpet in his office.

House, MD Season 3 Episode 303: Informed Consent

An aging scientist named Ezra Powell begins sweating and gasping for breath. He collapses to the floor.
The next day, House limps into the office with cane in hand. He gives his team the particulars of the latest case. They would rather talk about his cane, but House ignores every attempt to do so. House asks them to focus on Ezra, who cannot breathe. Chase and Foreman immediately recognize Ezra’s name from his renowned research. From the file, Chase sees that Ezra’s oxygenation has bottomed out and his lungs are full of fluid. He suggests amyloidosis. House would rather put the patient on a treadmill to figure out if the problem is in the heart or in the lungs.
The doctors submit Ezra to the test, but he can’t move fast enough to provide real results. As they wait for him, they discuss the return of House’s pain and what that means for them. Cameron wonders if there is anything they can do to help. Before she can continue, Ezra has trouble breathing. Unfortunately, his heart rate never got above 90 which renders the test useless. House advises Cameron to drain Ezra’s lungs and perform the test again.
Cameron still can’t get Ezra’s heart rate up even after his lungs were drained of fluid. He is simply too old and weak. House injects epinephrine into Ezra’s IV and this causes the heart rate to spike to 130. Nothing turns up on the EKG, meaning that the problem isn’t in the heart. House leaves the room and Cameron starts to remove the epinephrine from the IV. Ezra begs her to leave it in. He wants to die.
Cameron informs the team about Ezra’s wishes. House and Foreman are greatly opposed to euthanasia, and the others argue about what to do. Suddenly, every pager in the room goes off. The team rushes to Ezra’s room, where they find a nurse helping him back into his bed. The nurse found Ezra hanging off the bed with his tubes around his throat. Ezra refuses to consent to any more tests. House tries to force him into a breath test, but Foreman and Cameron stop him. House goes into exact detail about how he will die as his lungs fill with fluid, but Ezra isn’t swayed. House asks him for one more day. If he can’t figure out what it is in 24 hours, he’ll assist Ezra in dying.
The doctors immediately get to work on a battery of tests, rushing to beat the clock. Cameron checks Ezra’s laboratory for toxins. The next morning, House casually strolls into the lab and sees that his team has been working all night. He quickly notes a stack of tapes. Cameron explains that Ezra dictates his notes in the lab. House wonders if that indicates that he’s losing his memory. He orders an MRI to see if there’s a problem with Ezra’s brain.
A full day passes and the team comes up with nothing. House lies to Ezra and says that the bone marrow biopsy revealed multiple myeloma. They will need to draw some blood to start treatments. However, Ezra isn’t buying it. He knows that none of his tests have shown any indications of myeloma. House begs for more time, but Ezra refuses. There’s nothing the team can do but retreat to their offices.
House is deep in thought for hours. Finally, he pulls a leather case from his desk and heads for Ezra’s room. The team follows, bewildered. House unfolds the case, pulls out a syringe and vial and orders the team to leave the room. He wants them to make sure somebody sees them in another part of the hospital. Foreman steps in, but House orders him out of the way. Cameron is in tears. Chase draws the blinds. House injects the IV and Ezra goes limp. House quickly grabs the crash cart and asks Chase to help. House gets a laryngoscope and intubates Ezra so they can continue testing him.
House examines Ezra’s MRI and notices scarring on the top of his lungs. This, combined with the bad bone marrow, could indicate lupus. Foreman reports that the IVIG made Ezra worse, ruling out lupus. House asks Cameron to return to Ezra’s lab and find the January 1967 Massachusetts Medical Journal. There’s something in there that she might be interested in. In the meantime, he has Chase biopsy Ezra’s lungs and the results are negative.
Cameron reads the article and learns that Ezra once injected newborn babies with radioactive agents just to see if they had urethral reflux. House is confident that Ezra’s experiment, which was performed without consent, nicely reflects what he’s doing now. If Cameron thinks less of Ezra, she may change her mind and start helping them out. Yet she doesn’t bite.
Ezra crashes as the team finishes up the surgery. His right lung has collapsed, so House creates an incision in the chest to relieve pressure. He notices that Ezra reacts to pain stimuli on his left side but not his right. They need to wake Ezra up from his coma to run a somatosensory evoked potentials test to investigate.
House considers Ezra’s lack of sensation and orders a skin biopsy. He now suspects Kawasaki’s disease, lymphoma and sarcoidosis. The skin sample rules out sarcoidosis, so he throws out amyloidosis. The team counters that it didn’t show up in his heart. House presses, and Chase adds it to the stain. The slide immediately changes. The good news is that House was right. The bad news is that it’s protein type AA.
House informs Ezra that he has amyloidosis and, with a subtype AA, it is terminal. Ezra congratulates him on a successful diagnosis.
The next morning, Cuddy informs House that Ezra died overnight. The nurse charted that he was stable at 1:00am, but his breathing suddenly stopped at 1:30. Cuddy questions whether House knows anything about that. House asks if she would even want to know the truth.

House, MD Season 3 Episode 302: Cane & Able

A young boy named Clancy refuses to go to sleep and thinks "they" are out to get him. He turns on his TV. Suddenly, the channels begin changing and the room begins to rattle. A blindingly white light comes into the room. In the morning, Clancy's father Todd finds his son on the front lawn, face down. A large blood spot is on his behind.
House laces up for another jog. After leaving the house, he immediately comes back inside, grabbing his leg. He limps into the hospital. Cuddy and Wilson notice this, but House ignores them and takes the elevator instead of the stairs. Cuddy worries that House is depressed about his last case, causing him to slack on rehab. Wilson emphasizes that House only made a lucky guess. He still doesn't think they should tell him that the cortisol worked.
The team introduces House to Clancy's case. Cameron theorizes that rectal bleeding and alien abduction sightings are most likely sexual abuse, because trauma can cause the fantasy. Foreman deftly points out that the ER found no evidence of rectal tearing, semen or pubic hairs. House, rejecting hallucinations as a possibility, asks for a full set of coagulants and endoscopies from both ends.
Chase nicks Clancy's arm to time how long it takes him to stop bleeding. He clots with no problems. Clancy asks if the windows are locked because "they" know he's in the hospital. "They" put a chip in his neck to keep track of him that Clancy can feel. Chase pinches Clancy's neck with forceps, pretending to remove the chip. Clancy doesn't buy it.
Foreman and Chase report that both endoscopies were clean and the bleeding test was fine. House wonders if Chase screwed up the test. Later that night, Foreman tells House that he performed another bleed test on his own and it took twenty-five minutes to stop the bleeding. Cameron sensibly suggests running labs to check Clancy's clotting factors. Chase heads to Clancy's room for the new test. The boy is missing.
Chase finds Clancy in the men's room. He claims that he needed a windowless room so he could remove the chip. Chase cleans up the massive amount of blood from Clancy's neck and realizes there is something metal in the gash.
The metal is titanium from a surgical pin inserted into Clancy's broken arm from four years ago. House thinks that a small piece broke off and migrated. Chase finds it hard to believe that titanium could break. Even if it did migrate, how would it end up in the neck? House is more interested in the fact that Clancy cut open the back of his neck and clotted without bleeding to death. The case has changed from no bleeding disorder to a bleeding disorder and then back to being fine.
The team performs yet another blood test on Clancy. His mother, Stephanie, wonders if this was all in his mind because he had been looking for an alien tracking device.
Cameron receives a file on a returning patient and is stunned to find out that it's Richard McNeil, the paralyzed patient that House supposedly could not fix. McNeil is walking with assistance. He was afflicted with Addison's disease, and the cortisol shot turned his brain on like a switch. Cuddy comes in, dismayed to see that the patient she's been trying to hide from House is now out in the open.
Clancy suffers a pulmonary edema when blood is being drawn. Doctors rush in and frantically work to bring him back to life. Clancy holds steady but has a high blood pressure. Foreman discovers that Clancy does have a blood disorder, but it is von Willebrand disease. The doctors are baffled by the inconsistent test results. Cameron, referencing the high blood pressure, wonders if it is connected. Hypertensive crises can activate clotting factors.
They perform a transesophegeal echo to identify the problems in Clancy's heart, but the echo reveals nothing. House, determined to find something, insists that a small part of the heart isn't beating along with the rest. His team is unimpressed by a basic arrthymia. House instructs them to bring him a sample of the non-beating myocytes.
Cuddy tells House that she wants to do a PET scan on him to determine if his increasing leg pain is a positive or negative sign. House assures her that if he thought his leg was deteriorating, he would've been taking preventative measures by now.
Chase compares Clancy's DNA against the DNA taken from the heart. They don't match. House is at a loss for words. The team sequesters in the office for a differential. Wondering if the alien DNA is confined only to the heart, Cameron suggests introducing an antibody that recognizes only the protein from the other DNA and flush it through the body. If it shows up anywhere else, they will be able to find the DNA in other parts of the body.
They administer a PET scan on Clancy and spot a clump of affected cells in the bone marrow of the boy's femur. They also spot more cells in his heart and left eye. However, there is nothing in his brain, meaning Clancy's problem is not neurological. Surgery begins to remove the abnormal cells from each area. The normal tissue will begin to replace the removed areas and Clancy should be fine in time.
Wilson finds House in his office and tosses him a bottle of Vicodin. If he's so sure his leg is fine, why not take the pills so he can get through rehab? Wilson remarks that, lately, House hasn't always been right. Later, House hits the treadmill but runs with a noticeable limp. He gives into the pain and pops a couple of Vicodin. This allows him to keep jogging.
Clancy is asleep when the hospital room begins to rattle and the white light reappears in the window. Clancy floats above the bed. In reality, he is having a seizure. Chase rushes into the room as Clancy flails wildly.
The next morning, Foreman reports that the hallucinations and seizures indicate problems in the temporal lobe. Figuring that their antibody tag didn't penetrate the blood brain barrier, House asks them to go straight into the brain. Yet another PET scan of the brain is totally clean. House wonders if it's possible that something is there, but the antibody isn't affecting the brain proteins, which have a different cell structure. House retreats to his office to think in private.
After some deliberations, House instructs the team to send Clancy home. If they removed the affected cells and the brain was clean, there's nothing more they can do. Cuddy rushes to catch up with House in the parking garage, demanding to know why he's giving up on Clancy. House, knowing that Cuddy is displaying an unusual level of interest in his patients lately, asks what she's hiding. Cuddy admits that House was right about McNeil's case. A single shot of cortisol cured him. House thinks about what this means, mocks Cuddy for needing in vitro fertilization, and then is hit with a revelation.
Barging into the office, House asks his team how a person could end up with two strands of DNA. Referencing Stephanie's in vitro treatments, House asks if Clancy could be a twin. Two embryos in the IVF treatment bonded and Clancy is two people in one, a condition called chimerism. Now they have to cut out the second strain of DNA, some of which is in the brain.
Believing that the alien DNA was causing the visions, House plan to stimulate a hallucination during brain surgery. This will cause the secondary cells to light up so they can be removed. Both the plan and the surgery work perfectly.
House tracks down Wilson in order to gloat. He makes it clear that he beat their little scheme. Yet when he returns home alone, House pulls out one of his canes and starts using it.

House, MD Season 3 Episode 301: Meaning

At a family barbecue, Arlene McNeil watches in horror as her husband Richard, drives his motorized wheelchair into the pool and immediately sinks to the bottom.
On a beautiful fall day, House jogs through a park. At the hospital, Cuddy and Wilson discuss whether or not House would be interested in Richard’s case. A sweaty House bursts into the office, boasting that he ran eight miles to work. Aware that the ketamine treatment can wear off , Cuddy wonders if he’s feeling any pain. House declares that it’s been two months pain-free and he thanks her for the ketamine-induced coma. He looks over the case files and decides to take on two. One is Richard’s case. The other involves a 26-year old named Caren who became paralyzed when she snapped her neck during a yoga pose. X-rays show no evidence of spinal injury.
Wilson questions why he took Richard’s case even though there is no diagnostic work to be done. House is intrigued by the suicide attempt and claims that’s he is now a changed man. Wilson doesn’t buy it. House barrels into his office and starts discussing the cases before his staff can get into the niceties on his return to work. He becomes distracted by a spot of blood on the floor. It is his blood from the gunshot wound. He stares at it for a few moments, and then orders his staff to redo the tests on Caren and add an electromyogram. He then calls for an O2 mask for Richard so that he can perform tendon surgery on him. Richard’s leg muscles are atrophied, and House wants to make him more comfortable.
As Richard undergoes surgery, his son Mark insists that his father would never try to kill himself. House scoffs that the boy cannot know a man who hasn’t spoken for six years. House points out that if he did in fact try to kill himself, then that means he’s still present in mind. This reassures the family.
Cameron witnesses Arlene thanking House. She is incredibly curious to know what Arlene was thanking him for. Does this mean House has changed? House, of course, says nothing.
House learns that when they inserted the conduction pin for the EMG, Caren flinched. He picks up a lighter and holds it to Caren’s foot. She screams and jerks her foot away. Caren insists that she’s not faking, but House instructs his team to discharge her.
Later that night, Wilson asks House about observing Richard’s surgery with the family. Wilson realizes that the hallucination House had in his coma made him realize he wanted his life to have meaning. So he took an easy case to simply make a family feel better. Although House doesn’t deny this, he says he felt nothing when Arlene thanked him. Wilson advises him that his emotions, like his leg, had atrophied from disuse. He just needs to keep rehabbing his emotions. Before any further introspection can take place, Cameron comes to get House with a new issue involving Caren. She is struggling to breathe.
Strolling into her room, House informs Caren that she’s either faking it or she has pleural effusion. If she does indeed have fluid building up around her lungs, House will have to stab her in the back with a very big needle. House holds up the needle for Caren to see it, but she continues gasping. House notices something and has the team hold the patient down. He jams the needle into her chest. As he pulls up the plunger, the syringe fills with red liquid. They realize that Caren’s problem is in her heart.
The next day, the team discusses Caren’s case. House wonders if the paralysis was a delusion, indicating a neurological problem. Foreman recognizes that he’s leading up to a vascular tumor in her spine, but Cameron and Chase point out that the platelets are normal and Caren has been scanned thoroughly. House wants them to open her up and find the problem.
House notes that Richard’s heart rate has elevated. Deducting that he’s still in pain from surgery, House ups his morphine. Arlene thanks House for actually caring about Richard’s quality of life. Every other doctor has just wanted to fix him. House thinks about her words and leaves the room. Cameron, who has been observing from the hall, confronts him when he comes out. She’s all too eager to remind him about his past cynicism in the face of her optimistic hope. House changes the subject by asking her to dinner. Once again, House is in control of the relationship.
Cuddy summons House into her office to complain about the planned random search of Caren’s spine. House tries to barter with her, but has no success. Yet after a few more tests turn up negative, the exploratory surgery is scheduled. The surgical team preps Caren, and House sees something from the observatory. He bursts into the OR and shows Caren’s big toe to the surgeon. The nail is dark, corrugated and splintered. House has a clue.
Caren sits up in her room sipping orange juice as Foreman checks on her. He reveals that she had scurvy, which causes the arms and legs to fill with blood, making movement difficult. Caren talks about her modified Atkins diet and Foreman says that has given her a lack of vitamin C.
House makes one last check on Richard as Arlene prepares for discharge. She again thanks him and House advises putting Richard in a facility. She says she can’t abandon Richard. When she goes to lift him from his bed, Richard makes a low, guttural, gurgling sound. House asks Richard to do it again. House announces to Arlene that Richard is talking.
House enters his office carrying a box overflowing with eight years of medical files on Richard. House tells the team Richard grunted last night, then instructs them to review Richard’s history with the grunting in mind. House then goes outside to skateboard but feels a twinge of pain in his leg. He immediately stops riding and walks back inside.
After poring through the files all day, Cameron, Foreman and Chase have written down the 214 symptoms Richard has experienced in the last eight years. Looking over the extensive list, House thinks that abdominal pain plus everything else could mean a pancreatic cyst. Cameron quickly points out that abdominal pain is one symptom that Richard never had. House counters with the fact that Richard could never vocalize the symptom. He orders an upper endoscopic ultrasound.
Chase and Foreman prepare for the procedure. Before inserting the scope, Chase asks Foreman to bring the crash cart closer, figuring they’re going to need it shortly when Richard’s throat closes on the scope. Chase slides the scope down into Richard’s stomach and they see that the pancreas looks clean. Before they can continue, Richard’s throat does indeed close. They perform an emergency tracheotomy.
Reviewing the details of the procedure, House tries to figure out why a sedated throat would collapse. He realizes that the muscles actually locked down. Since the brain is supposed to tell muscles to contract and relax at the same time, something was blocking a relax message from the brain to the throat. Cameron stops House and begs him to let this case go and stop torturing Richard to satisfy his own curiosity. House thinks about a few microtumors in the meninges of Richard’s brain and considers looking at the brain lining.
In the CT room, Chase injects contrast material into Richard’s spine and slides him into the scanner. He is forced to stop the test when he notices blood trickling from Richard’s ear.
The team finds House in a light board room, surrounded by eight years’ worth of x-rays and scans. Chase reports that a surgeon repaired Richard’s CSF leak. House asks Foreman to walk him through the brain scans throughout the years. House then wants to do five millimeter cuts through the occipital and hypothalamic regions. While both Foreman and Cameron refuse to keep putting Richard through risky tests, Chase is still up for it.
Despite House’s persistence, Cuddy decides to discharge Richard the next morning. That night, House goes for another run. Dripping with sweat, he jumps into a fountain to cool down and the water gives him an idea. He rushes over to Cuddy’s house and pounds on the window in the middle of the night. She rouses from her sleep and opens the window to find House immediately launching into his theory. Richard’s brain is on fire because of an imbalance. He drove his wheelchair into the pool because he couldn’t regulate his body temperature. He had hypothalamic dysregulation. Cuddy refuses to allow any more treatment -- not even a simple cortisol shot that House claims will prove his theory.
The next morning, Arlene and Mark wheel Richard out of the hospital. But Cuddy stops them before they reach the door and injects Richard with cortisol. She then looks into Richard’s eyes waiting for a reaction, but there is none. Suddenly, Richard goes into spasms. He moves his arm and undoes the seat belt on his wheelchair and slowly stands. Cuddy tears up as she watches the family’s joyful hug.
Cuddy is about to track down House to tell him what happened when Wilson stops her. Calling it a lucky guess, Wilson says it’s more important for House to learn to be reined in.
Late that night, alone in the hospital, House sneaks into Wilson’s office. He finds Wilson’s prescription pad and writes himself out a scrip for Vicodin.

House, MD Season 2 Episode 224: No Reason

House examines a man named Vince who was admitted with a severely swollen tongue. He asks Vince questions to get him to speak funny. In House’s office, Foreman assumes it’s simply a routine case and walks out. Another man named Jack comes into the office and asks for House. Jack identifies himself as a former patient, then pulls out a gun and shoots House. He asks House if he’s shocked.House wakes up in a hospital bed. Cameron is at his side. He feels his beard and can tell that he’s been out for two days. His first words are to chide Cameron for waiting. She tells him that the bullet pierced his stomach, nicked the bowel and lodged into the posterior rib. Cameron tries to explain to him what Jack had to say. Yet House is more interested in Vince’s tongue. Jack’s bed is wheeled into House’s patient room. He was shot by security when he tried to leave the hospital. House gets out of bed and starts walking to Cuddy’s office.
House complains that somebody screwed up his surgery because he can no longer feel pain in his leg. Cuddy thinks this is serendipitous, but House is worried that the surgeon messed up his nervous system.
In the ICU, House lowers Jack morphine and asks why he tried to kill him. Jack says if he really wanted to kill him then he’d be dead. Jack wants House alive because he wants to see him suffer. House disconnects the man’s morphine completely to torture him.
The doctors follow House’s instructions and biopsy a lymph node in Vince’s lower jaw. They report back that the test was negative. They cannot give Vince a lumbar puncture because of the high intracranial pressure in his head. House orders them to do the LP anyway. While performing the LP, Foreman notes that Vince’s pressure becomes normal.
Jack explains to his roommate House that he had treated his wife and cured her. In the process of the treatment, House emphasized the importance of knowing everything. This caused Jack to confess to an affair. Although the affair had nothing to do with the wife’s brain aneurysms, House told the wife about the infidelity. She later killed herself. House completely rejects this as an excuse.
House spots an attractive woman looking into Vince’s room. He is quite surprised to find out this woman is married to the very plain and overweight Vince. House doesn’t hesitate to tell her so. Having been warned about House by another friend that he had treated, the woman swats his questions easily.
Foreman and Chase discover that Vince is bleeding into his ocular orb. Chase recognizes tremendous pressure behind the eye. Before Foreman can relieve the pressure, Vince’s eye pops out.
House tears his stitches while walking the hallway. He collapses with blood coming from the wound. Back in his room, House and Jack argue over who to blame for the suicide. House denies any culpability, and Jack angrily says he knows it’s his fault. House admits that he’s partially at fault, but once Jack pulled the trigger he lost the right to an apology.
House escapes from the hospital to a local taqueria with his team where he throws out possible causes for Vince’s ailment. House wonders why Vince’s eyes and tongue were affected while his nose was spared. The problem may have a common source like the brain. Although a previous CT scan proved clean, House wants them to recheck the brain for what might be hiding. They must also biopsy the blood/brain barrier which is an incredibly dangerous procedure. Chase suggests testing for STDs, but House doesn’t think the wife sleeps around. And Vince certainly wouldn’t stray on a wife so far out of his league. Cameron is confused because Vince is a widower who is not married.
House complains to Wilson that he might have hallucinated the attractive women. Records show that Vince has had only six visitors. House frets that he’s losing his logical mind. Wilson encourages him to take two weeks to rest. House is still worried that the surgery screwed him up, and he wonders aloud why he was giving ketamine during the surgery.
House finds Cuddy and accosts her about the ketamine given to him. He wasn’t given simple anesthesia but was induced into a coma. Cuddy sees that House is now walking without a limp and exclaims that it worked. This stops House cold. Cuddy says that a clinic in Germany has been treating chronic pain by inducing a coma, which basically allows the brain to reboot itself. There’s a 50% chance that House’s pain will never return. House accuses her of having no right to do that. Cuddy scoffs that all she did was cure him.
Vince’s blood/brain test comes back negative. Yet the team found blood on the wrong side of the barrier. House wonders that, if Vince’s lymph nodes are not functioning properly, where would the trash they handle go? He starts to recite a metaphor about trash and garbage cans. Chase quickly figures out that House is referring to the chest lymph which is the next closest lymph system. He heads off to take a sample. House questions how Chase answered his riddle so quickly. Jack mocks him by saying that he’s getting dumber.
Cameron and Foreman come to House with the news that this latest test was also negative. Chase walks a post-op Vince to the toilet so that he can urinate. Vince cries out in pain. Chase leans around to look at what’s causing the problem and blood splatters on his face. Vince’s scrotum has burst. The team tries to find more possibilities. Foreman throws out testicular cancer.
Wilson tells House that testicular cancer could indeed rupture a vessel. House knows this, but is concerned that he did not think of it earlier. House becomes angry that he had to trade a good brain for a bad leg. Wilson thinks House needs his bad leg to define himself, as an excuse to always act miserable. Without it, House doesn’t have himself anymore. House asks why Wilson is defending Cuddy. House notices that Wilson seems like he’s known about Cuddy’s decision for longer than he lets on.
House blasts into Cuddy’s office and begins screaming that all he has is his brain. She had no right to put him into a coma. Cuddy and Wilson are equally angry, saying that they were only trying to help him. Cuddy complains that House’s morphine use had been spiraling out of control. House punches Wilson in the face. Wilson laughs and asks House if he’s hallucinating.
House comes to in his ICU bed, staring at Jack. He had been hallucinating. Jack says that he was calling him Wilson, but House denies it. Jack isn’t surprised when House mentions that his hallucination involved a bathroom. He coolly informs House that he wet his bed. The team enters with a negative result on Vince’s testicular cancer. House calls for a cystoscopy. It too comes back negative.
House is more interested in the fact that he can easily run up and down the stairs. He darts past the team as they throw out more possible causes. Suddenly, House stops in his tracks and asks them how he got there. He remembers being in the ICU and he remembers being on the stairs with them. He doesn’t know why he’s still on the stairs with them at the bottom. The team doesn’t know what to say.
House tells Cuddy that he’s dropping out of Vince’s case. He is suffering from blackouts and fears he is losing his mind. Cuddy asks if he intends to scare her. House wants to know why she jumped up when he came in. She claims it is because of their last angry encounter, which House knows was a hallucination. Is this also a hallucination? House wakes up in the ICU.
Over more tacos, House asks Jack how he can tell what’s real and what isn’t. Everything seems the same. House is aware that this conversation is actually a give-and-take with his own mind. Jack explains that House is concerned that he will base his actions in the real world on fantasized information, then he can cause genuine harm. Jack advises him to take no actions until his mind has settled. He should only throw out ideas and trust his team to know which thoughts are useful and which are possibly fatal.
House learns from the team that the prostate exams also came back negative. House asks them what it means if something doesn’t make sense. He makes it clear that this is not rhetorical. He needs actual help from them. House asks them very basic questions, and the team is lead down the path of surgery because the biopsies aren’t telling them enough. However, Vince’s bleeding problem makes surgery fatal. House asks about performing a surgery that’s less bloody than a paper cut.
Cameron informs Vince that they would like to use a robot to operate on him, but Vince is resistant. Cameron explains that the robot can magnify everything ten times to let them see things they ordinarily could not see. House is forced to take him to the robotic operating room to show him. House lays Cameron on the table for a demonstration, showing Vince that the machine won’t let the surgeon do anything that doesn’t compute medically. He uses the scalpel to slice a button off of Cameron’s blouse and the clamps to pull it open. Vince agrees to the procedure.
House works on Vince’s case from his hospital room. Jack interjects that House does not care about emotions. He only cares about measurable truth. Even though he cannot measure emotions, doesn’t mean they’re not real. House begins to see a car with the attractive woman from Vince’s room. The woman is actually Jack’s wife. She has a car engine on in a closed garage to kill herself. House hears Jack’s voice in his head telling him that he is miserable for nothing.
Snapped back from his vision, House apologizes to Jack. More importantly, he knows what’s wrong with Vince. House walks into the robotic surgery and tells Cameron that Vince will be fine. House asks the team why they haven’t yet tried to yank him off the case. They say that they trust his judgment and have worked with him long enough to know what he wants. House asks why they have identical knowledge. He announces that they are all visions in his head. House seizes the robotic control and attempts to drive the scalpel into Vince’s stomach. The team tries to stop him, but House needs to know if this is a hallucination. The scalpel rips open Vince’s stomach and blood flies everywhere as Vince’s vitals drop. House staggers over to the body. Vince drops a bullet from his hand and House picks it up.
The doors to the ER burst open. Cameron, Chase, Foreman and the EMTs wheel a bloody House through the hallway. Chase barks orders to the team that House was shot once in the abdomen and once in the neck. Before he passes out, House asks Cameron to tell Cuddy that he wants ketamine.

House, MD Season 2 Episode 223: Who's Your Daddy

Sixteen year-old Leona is on an airplane with her father, Crandall. Leona is black and Crandall is white. Crandall has taken Leona in from her troubled mother. Leona hallucinates that water is gushing out of the cockpit to flood the cabin. This is similar to what she experienced in the hurricane that devastated New Orleans. Leona’s heart races, then stops. She collapses on the cabin floor.House’s leg is causing him tremendous pain, but when he searches for Vicodin in his home he only finds empty bottles. With tremendous effort, he climbs onto a stepstool to reach a lockbox on the top of his bookshelf. He takes out a syringe and a vial of morphine. As he is about to inject, House hears Cuddy leave a message on his answering machine. She has admitted a teenage girl with cardiogenic shock but no heart attack. House becomes intrigued and puts down the syringe.
House goes to the hospital, and Cuddy informs him that Leona’s EEG and EKG are normal, she has no signs of infection and the tox screen came out clean. Her heart looks fine. House realizes he knows Crandall from his younger musician days. Crandall explains that Leona’s grandfather was Jesse Baker, a famous jazz musician that they both idolized. Leona lost her mother in Hurricane Katrina and Crandall is her natural father. House is convinced that the mother lied to him because Crandall always was a trusting sucker.
The team tosses out possible causes and Houses asks them to retest everything that was checked in the ER. He considers the possibility of arrhythmia but it would not cause a hallucination. They would have to keep Leona under observation for months to spot another arrhythmia, so House intends to induce one. Cameron thinks it’s too risky, but House presents the option to Crandall. House advises Crandall to sign the consent form even though the test is dangerous. He then asks Crandall for a DNA sample so he can run a paternity test. He thinks Leona is just using him.
In the electrophysiology lab, Chase threads a catheter through an artery and into Leona’s heart. The sinoatrial node is normal. Yet when Chase pushes into the atrioventricular node, the heart goes into a supraventricular tachycardia. The EEG shows normal brain waves, so there is no hallucination. House asks Chase to reset and continue the test but Chase balks, concerned that Leona’s heart is fragile after the last attack. House presses him to do it. As Chase enters the next mode, near the cornary sinus, the EEG goes wild. Leona is now hallucinating. Chase freezes a tiny area of heart tissues near the probe and everything returns to normal.
From her room, Leona hears a woman asking for water. She pulls back the curtain and finds a bloated corpse with water pouring over it. Leona, who is really still in her bed, sits up and screams.
Cameron reports that they haven’t fixed Leona’s heart. Chase insists that the heart is fine and the hallucination must have another cause. House proposes an atypical seizure rather than a hallucination. As he discusses the case, House repeatedly exits the room to pace in the hallway. The team realizes he’s trying to walk off leg pain. House comes back in and tells the doctors the fact that they predicted, found and cured Leona’s heart problem means the hallucination should just be a coincidence. What if it was caused by the pain of the arrhythmia? Leona might have a disease that translates pain into bizarre physiological responses like hallucinations,
Picking up on this, Cameron considers the fact that Leona may have an autoimmune disease so she recommends a CRP, ANA rheumatoid factors and cryoglobulins. House believes a PET scan will test her response to pain. House straps Leona into a PET scan, assures her that this won’t hurt, then jams a syringe into the meat of her palm. Leona screams, but Foreman reports that the cerebral cortex response is normal. House then jams the syringe into her thigh. Leona begins crying as House grills her about Crandall and her real father. He then bends her middle finger backward as Foreman reports the dorsolateral prefrontal cortex also looks fine. Crandall rushes into the room to stop House, and that’s when the PET scan lights up. Leona starts to hallucinate.
They confirm that Leona has an autoimmune disease, but they need to discover which one. House suggests killing them all at once. Cameron points out that this would require replacing her entire immune system. House is fine with that, but a bone marrow transplant requires an exact match and Leona has no siblings. House walks off. Crandall barges into House’s office and reasserts that he’s Leona’s father. Crandall demands that House test his marrow. House tells Crandall that he has been scammed. This is not the first time he’s been taken.
House and Wilson watch Leon go through radiation. House says that Crandall is not a marrow match, although he didn’t do a paternity test per Crandall’s request. A match was found in the marrow registry. House notices black goo oozing out of Leona’s mouth. House and Wilson have no idea what it is.
The lab results on the goo come back, but House already knows what it is. True to his suspicions, the goo contained stool and digested blood. He recognizes a reverse peristalsis. In order for digested blood to be in the intestines, Leona must have internal bleeding. There must also be a blockage forcing the material up and out of the mouth. Foreman tosses out liver failure. With no proteins to clot blood, it could leak into her stomach. House realizes that this means they were wrong on autoimmune disease. Nothing would shut down an organ in two hours. He orders a liver biopsy.
House finds Crandall and tells him that they need a liver biopsy, but are not sure what will happen. Leona could die the second they stick a needle into her liver. Foreman and Chase begin the biopsy. The needle is millimeters away from Leona’s liver when House pages Foreman with instructions to stop.
In House’s office, he plays some of Jesse Baker’s music for the team, He wants them to hear an uncut portion when a drunken Jesse rails at an engineer for not tuning his piano correctly. The team is unimpressed, but House points out that the piano was not out of tune. If Jesse was drunk, his playing would be off. He is playing perfectly. Something else is ruining his personality, and House believes his aural perception was off. Combined with Jesse’s fatal liver failure, this means he had too much iron. Jesse could have had hemochromatosis, which is genetic.
House takes the doctors to Leona’s room and shows them a picture from Crandall’s book about Jesse. Leona was thirteen then, but her skin is darker now. House attributes this to grayness from direct iron deposits in the skin and tan from too much melatonin. Both symptoms are products of hemochromatosis. House asks for a SQUID exam to calculate the amount of iron in the blood. He prescribes desferoxamine as a treatment, assuming she will be fine after that. A subsequent MRI does indeed reveal lots of iron on Leona’s liver.
Chase starts Leona on an desferoxamine IV, explaining to Crandall that the chelating agent will bind to the iron so that the liver will be able to process it. As the medicine drips into Leona’s bloodstream, she starts gasping for breath. Chase urgently intubates. A CT reveals that Leona’s lungs are basically swiss cheese. Chase thinks her time is up.
House starts over, asking what is supposed to happen when desferoxamine is introduced. Chase explains that iron is heavy and gets stuck. The desferoxamine bonds to it and acts as a lubricant so the iron can be processed and discharged through waste. Yet now, Leona’s waste is heading north, not south. Has the iron moved into her lungs? Oxygen will attach itself to iron, which increases the chances of infection. They had put Leona on antibiotics earlier to prevent infection and try to figure out what else would attach to iron. Cameron brings up neurodegenerative disease with brain iron accumulation, but there are no iron deposits in the brain. Foreman inquires about fungus, and Chase points out that there are 25 antifungals. House asks them to go broad. Cameron says the most common fungus is aspergillis. House orders them to continue ventilation, start a voriconazole drip and hope Leona has aspergillis.
Wilson has a sudden revelation. House did the paternity test, but it came back positive, so House simply dropped it. They get word that Leona’s lungs have collapsed because they have diagnosed the wrong fungus. House gathers the team and asks them to consider location.
House goes to Leona’s room and informs her that she has a fungus. If she’s lying about living in a children’s shelter before Crandall rescued her, she could die. Leona blinks, indicating that she was lying. House gives her a pad and pencil, asking where she actually was.
House reports to the team that Leona was holed up in Jesse’s recording studio. Cameron deduces that soundproof recording studios also absorb moisture. Hurricane Katrina, with its incredibly levels of mold, created zygomycosis in the studio. House asks for an IV drip of amphotericin B and colony-stimulating factors. He declares for a third time that they’ve solved the problem and that Leona will be fine. As Foreman hooks up the IV, he tells Crandall the truth about where Leona was.
House visits with Crandall and Leona. He asks Crandall why he thinks he will be a good father. Crandall replies that it feels good. House then chases Crandall out of the room and admits to Leona that he did run a paternity test. Crandall is her father. That night, House relaxes at home with the music of Jesse Baker. He examines the paternity test for Crandall. It’s negative.

House, MD Season 2 Episode 222: Forever

Brent Mason is woken early by his crying baby. He starts to gag over the sink and his wife, Kara, begs him to stay home for the day. Brent leaves the house, but collapses and vomits. He returns home to find Kara in the bathtub with the baby. She’s having a seizure and the baby is underwater.The EMTs wheel Kara and her 4-week old into the ER. Chase goes to work on both of them. Meanwhile, Wilson gloats to House that Cuddy asked him to dinner and he thinks she wants to suck up to him for some favor. House is sure that she’s up to something.
Cameron has Chase’s case from the ER, but she must wait to present to House because Foreman has returned. Foreman is happy to be back at work, but House is skeptical. He asks Foreman to make coffee, and watches as Foreman struggles to open the bag of grinds. Although he still has some spatial analysis troubles, Foreman says his left side/right side reversal is gone and everything else is basically fine.
Cameron brings up the ER case again, but House dismisses the simple seizure diagnosis boring. Foreman calmly and easily diagnoses the epilepsy with elevated calcium levels as either hypertherothyroidism, cancer, or calcium-mediated neurotoxicity. Yet Foreman can’t diagnose how the coffee maker works. The ER has already ruled out all of the obvious and simple explanations, so House becomes interested. Cameron suspects Whipple’s and House considers vasoconstriction. Chase just thinks it’s strep, since Brent is also sick, but he cannot help the team because he is stuck on neonatal intensive care duty.
Cuddy arrives at her office to find House waiting. He wants to know why Chase is in the NICU. Cuddy claims that they are short-staffed there, but House knows that is a lie. He realizes that Chase asked for a new assignment.
Kara and Brent test negative for strep. Cameron jokes about Foreman’s health, and he says it doesn’t matter because he is alive. His worst case scenario is to teach. Cameron is confused, and she asks about his dreams of landing grants and running his own department. Foreman answers that if he cannot figure out the coffee machine by then, he doesn’t deserve the chance.
Chase makes the rounds in NICU when baby Michael Mason begins crashing from a lack of oxygen. At the same time, Cameron struggles with Kara in the MRI. The woman tensed up as Cameron inserted a catheter, and blood went flying. Yet this is not a seizure because Kara’s muscles aren’t contracting. She is so tensed that her back is completely arched.
The team meets in the NICU to figure out what causes seizures, hypercalcimia and the rigidity. Chase is there, examining x-rays of Michael’s lung. He suggests lithium as a cause of all three symptoms. Foreman throws out myluminous meningitis. House likes that and orders an S-PAP and an MRI. Then he advises Chase that Michael’s lung problem is bacterial, not chemical. House asks Chase point blank why he doesn’t want to work with him. Chase says he just needed a break from the intense pressure. House isn’t buying it.
House brings Wilson items from Cuddy’s trash -- a receipt from a pharmacy and an empty box of Red Clover. Both doctors know that Red Clover is used for cancer. House observes that Cuddy asked an oncologist to dinner instead of any other doctor in the department. House thinks that this isn’t a date but a consult.
Cameron reports that Kara tested negative for meningitis, but she is bleeding into her brain. Foreman, who searched the Mason home, only found a hidden bottle of vodka. Cameron is ready to believe that alcoholism is the cause, but Foreman goes deeper into the history. He thinks that, with the family’s growing debt and the new baby, Kara developed conversion disorder where psychological stress presents itself physically. House is leaning more towards alcoholism. Since Kara’s tox screen was negative for alcohol, he orders a phenocoma as treatment for DT. Foreman walks out without objection, which irks House. He questions why Foreman isn’t defending his point, but Foreman says that House would have overruled him because he had probably considered the father anyway. Besides, Foreman is a changed man.
Brent and baby Michael come in to see Kara before her coma is induced. She apologizes for what she did, but Brent doesn’t blame her. Foreman informs House that the happy Mason couple met in AA. Obviously, Kara had a relapse. House looks into Kara’s room and sees her with her back to the hall. The baby is missing from the bassinet. He and Foreman race into the room to find her smothering Michael. Foreman pulls her away as House grabs the child. With Michael unconscious, House calls for the crash cart and begins infant CPR.
Foreman explains to Brent that Michael is stable, but the lack of oxygen caused kidney damage. Brent concludes that Kara accidentally rolled over in her sleep, but Foreman says that he witnessed it. Brent refuses to believe it. In her room, Kara tells Cameron that the voices told her that Michael would be better off dead.
When the team reconvenes, Cameron now theorizes that Kara faked the seizure when Brent caught her trying to drown the baby. Foreman thinks the seizure was real. The postpartum made her try to drown Michael but the stress caused the seizure. House wonders why nobody is talking about actual physical illnesses anymore. Foreman thinks he has a point, and offers to draw some blood. This drives House insane. He begs Foreman to start sticking up for himself. He wants Foreman to stress Kara into another seizure. House instructs them to take her off haloperidol, hook her up to an EEG and start flashing lights. If Kara starts twitching, the machine will tell them if the seizures are real.
House wants to know how Wilson’s dinner with Cuddy went. Wilson says that it was a real date and that cancer never came up. House asks why he is in the lab doing a PCR test from a spoon. He deduces that it must be Cuddy’s spoon from dinner. Wilson admits that he’s checking her saliva for cancer markers. House tells Wilson to find him when the results come in.
Chase tells Brent that he needs to start Michael on dialysis. Because of the kidney damage, the boy’s potassium level is rising and if it doesn’t come down then he will have a heart attack. The stress test on Kara is completely uneventful until Cameron notices that the brain activity is slowing down. Foreman and Cameron look into the room, only to see Kara grasping and sucking. This, combined with muscle rigidity, means encephalopathic delirium. While this is an actual physical illness to work with, the progressive nature of the case means it can’t be long before Kara’s brain shuts down entirely.
Baby Michael suffers a heart attack and Chase tries to shock him back. The team is stumped for causes. House throws out pellagra and Foreman agrees with it, pointing out that alcoholics have horrible diets and often lack niacin. This starves the brain, which causes everything Kara is suffering from. Chase brings the team the news that Michael is dead.
Foreman pulls Kara out of her coma and asks her a simple question to test her acuity. She is more interested in finding out where Michael is. Foreman informs her that the pellagra was making her believe things that weren’t real, and Kara confesses that she remembers doing things to her son. Foreman breaks the news that Michael is dead. Kara wails in agony and then vomits.
Foreman finds blood in her vomit, which is not caused by pellagra. Whatever Kara has is getting worse. Thinking about the dead baby gives House an idea. He finds Brent, who is cradling Michael’s lifeless body. House tells him that the baby had the same condition as Kara. Yet House cannot biopsy her because she will bleed to death. House needs the baby, but a resentful Brent won’t hand over the child to help his wife. House angrily turns things around on him, pointing out that he was drinking as well. If he made any effort at all to pay attention to what Kara was going through, then he would have picked up on her symptoms before it got this far. Brent agrees to the tests.
House lets Chase know that Michael’s body is available for tests, but Chase isn’t interested. House then holds up Chase’s paycheck and asks why he’d be working in NICU while using his vacation days from House’s staff. He wants to know why a rich boy like him need the extra money, especially when his late father left him money. Chase coldly responds that he’s not rich.
Before performing the test on Michael, Chase says a prayer for strength. He reports to the group that Michael’s intestines show slight villous atrophy. House asks the team how polystyrene treatments could cause flattened villi. Foreman points out that the polystyrene itself couldn’t cause that, but House wants them to look at the binding agents. Cameron brings up wheat gluten. Both Kara and Michael had celiac disease, an affliction where the body cannot process gluten. Each time the gluten was introduced to the body, the small intestines were further damaged, until they reached the point where they couldn’t receive vitamins and minerals. This led to the niacin deficiency, which created the other problems. Celiac is also why Michael’s medicines didn’t work. His body couldn’t absorb them. Additionally, celiac patients are susceptible to cancer of the stomach lining, which would explain the bloody vomiting.
Wilson announces to House that Cuddy is negative for all cancer markers. House goes to Cuddy’s office and tells her that she doesn’t have cancer. She’s more than a little surprised by the test results, mainly because she didn’t know that tests weren’t being run. Cuddy’s estrogen is too high because she is on fertility meds. Her dinner with Wilson was an audition. Cuddy confesses that she’s looking for a sperm donor, not a partner.
Kara refuses treatment. House visits with her and learns that she feels guilty about killing her own son. House assures her that she’s blameless because she is now healthy except for the cancer. Kara still declines treatment.

House, MD Season 2 Episode 221: Euphoria Part 2

House implores Cuddy to let him take a sample from Joe’s brain. She refuses because Joe’s death made this a bio-safety hazard. The CDC will perform the autopsy and return results to them in three days. House points out that Foreman might be dead in 36 hours, but Cuddy doesn’t budge. They don’t have the tools to do this safely, so it’s out of her hands.House comes up with an idea, and he heads down to the isolation room. He slides an ice pick and hammer through the airlock, telling Foreman to cut into Joe’s eye in order to extract some brain tissue. Cuddy rushes down and orders Foreman to stop. She then has another doctor suit up and enter the room to restrain Foreman. House presses Foreman to continue. Instead of slamming the pick into Joe’s eye, Foreman drives it into the mattress. Foreman senses that it didn’t feel right, but he removes a sample from the mattress anyway thinking that it is Joe’s brain. Realizing that Foreman has Anton’s Blindness, House asks Cuddy if she still wants to wait for the CDC.
House, Cameron and Chase convene for a differential diagnosis on Foreman. They throw out various diseases, none seeming likely to be the culprit. House orders them to start treatment for everything they can think of. He leaves to find another brain to biopsy. Even though they are worried that a heavy regimen will trash Foreman’s organs, Chase and Cameron slide the pills to him. Foreman feels each pill and discerns what it is for. He realizes that they have no idea what’s afflicting him and grudgingly takes the medication.
House goes to Joe’s apartment in a biosuit. He has the rat that he trapped in Stacy’s attic months ago with him. He calls Foreman in the iso room and asks him to detail his steps. House carefully inspects each area, making sure to expose the rat to everything that Foreman was around. When House hangs up, Foreman calls his father.
The next morning, Wilson finds House staring intently at his computer. House has set up a webcam to monitor the rat in his own kitchen. As soon as the rat becomes sick, House will perform an autopsy.
Cameron draws blood from Foreman and he notices that she left the tourniquet on his bed. His vision is returning in response to the treatment. Yet which treatment worked? House wants to stop individual medicines one by one to find the one that caused a regression in his vision. Before Cameron can do anything, Chase reports that Foreman’s amylase and lipase levels are three times the normal level. His pancreas is failing due to the meds, which must be stopped immediately.
House goes to Foreman and tells him what’s happening with the meds. Foreman asks him to lower the dosages, but even lower doses would be toxic. If they continue the meds, Foreman will appear to see for the next four hours until he dies. If they stop, he’ll lose his vision but buy time for a diagnosis. Foreman agrees to cut the meds.
Foreman’s father Rodney arrives, and House explains to him that a brain is available but Cuddy won’t allow them to autopsy it. House then escorts Rodney to Cuddy’s office, and the man questions her about her decision. Cuddy struggles to give him an answer, and explains that the deadly infection Foreman has could put many more lives in danger. This Rodney understands.
Foreman assures his father that it won’t be a painful demise. Wilson catches up with House outside of the morgue to report that the rat is still healthy. He also has noted that House is preoccupied with the guard stationed in front of the cooler holding Joe’s body.
Foreman’s vision regresses and he has reached an eight on the pain scale. The disease is progressing faster than it did in Joe. House is slightly encouraged by the anomaly and asks the team what that could mean. Cameron comes up with the fact that many diseases affect blacks differently than whites. House has them look up all bacterials, fungals, toxins and parasites to find any documented racial disparities. House remembers that the rat is still perfectly healthy and he thinks perhaps that’s the difference between Foreman and Joe.
Cuddy visits Foreman in isolation. He’s enraged that she won’t ignore CDC policy to help save his life. House comes in and announces to Foreman that he’s dying too fast. He holds up a vial holding legionella pneumophila. Joe had Legionnaire’s disease when he got infected, and it somehow slowed down the progression. Joe didn’t die until they cured the Legionnaire’s. Foreman refuses to inject himself. House simply opens the door to the isolation chamber and tosses the vial in. It shatters.
Cameron watches as Foreman takes his own temperature. It’s down to 101.0, and Foreman reluctantly admits that his pain is no worse. He did contract Legionnaire’s, and it has indeed slowed the progression of the mystery disease.
With the rat still not sick, Wilson wonders aloud what House will do if the rat never falls ill. House has a realization, and declares Wilson’s suggestion as brilliant. He walks out and asks Cameron what illnesses affect humans and not rats. House then tells her that she didn’t become sick because whatever it is isn’t blood-borne.
Chase suggests that some bacterial infections don’t affect rats, but Cameron counters that Foreman has tested negative for every bacterial infection that affects the brains. House observes that when they test for bacterial infections, they’re really looking for antibodies. The body might not be fighting the infection. If the body doesn’t recognize the first infection, that infection will run rampant through the body. Yet when Legionnaire’s is contracted, the body does recognize that and increases white cell count to stave it off. The body unintentionally fights the first infection as well. They need to figure out what bacterial infection affects humans and not rats which the body is unlikely to recognize.
House informs Foreman that the answer is Listeria, so he will start him on Amp and Gent. He puts the antibiotics in the airlock, but Foreman requests certainty. He asks House to perform a white matter biopsy. House refuses, because any slip will render Foreman an invalid. Foreman fears the antibiotics will bring back the pain if House is wrong. House begs him to try the medicine first. If it doesn’t work, he will biopsy the brain again. Foreman takes the pills.
As Cameron changes the antibiotics IV bag, Foreman writhes in pain. He implores her to put him in a coma, asking her to be his medical proxy. He quotes from her medical journal article about the importance of a well-informed decision. Foreman then apologizes for stealing her material for his own article. She agrees to be his proxy, but doesn’t forgive him for what he’s done.
Chase finds Rodney Foreman in the hospital chapel and lets him know that they need to put his son in a medical coma. However, if they cannot solve the problem, he won’t wake up. Chase suggests that he visit his boy before that happens. Rodney dons a bio suit and spends a few moments with Foreman before Cameron induces the coma. As she administers the IV, Cameron tells Foreman that she accepts his earlier apology.
Wilson implores House to perform the biopsy, dismissing House’s claim that it is too dangerous. Wilson asserts that House doesn’t spend time with patients because he’ll get close to them. If it were anyone else, he would have drilled into their heads long ago. Cameron reports that the EEG shows that Foreman is still in pain. She demands they do the biopsy now. House still refuses. Cameron hands him the paper showing her legal proxy status.
Cuddy confirms that the proxy letter checks out. She instructs Cameron to proceed with the biopsy and ignore House’s interference. Cameron remarks that Cuddy is no hero because they could have cut into a dead man’s head long ago. Cameron then apologizes. House follows her out and begs for an hour. He wants to go back to Joe’s apartment and to see if another animal died. The place was such a dump, there must be more vermin there. If House finds something, he can cut its head open instead of Foreman’s. Cameron tells House that when Foreman’s O2 stats hit 90, she must proceed.
House, not wearing a biosuit, again inspects the apartment. He notices a pigeon hit the window and the rooftop shed. The bird is blind. House stalks the bird, but it flies off.
Cameron readies the neurosurgery tools. Cameron calls House to announce that she is about to proceed, but House tells her that the water Joe uses for his marijuana might be the answer. Cameron already tested that water and it is clean. House is stumped. Foreman’s O2 stats drop to 89, so Cameron starts the biopsy.
House follows the piping to a water tank. He quickly calls Cameron to say that they tested the wrong water. The tank he found is riddled with Naegleria. She already knows this because her biopsy showed the same results. House is dismayed.
Cameron finds Rodney Foreman to let him know that his son has primary amoebic meningoencephalitis, which is a parasite that goes through the nose and migrates into the brain. There it feeds on brain cells. It is treatable and will cause no lasting damage. However, they don’t yet know if the surgery or coma produced any side effects.
Foreman gets transferred from isolation to the ICU. He comes out of the coma and doesn’t feel any pain. House tests his vision and Foreman successfully follows his finger. House then asks Foreman to identify the people in the room. Foreman realizes that they performed the biopsy. He successfully names Cameron, his father and House. House then asks Foreman to wiggle his left toes. Although Foreman says he moved them, his toes remain still. House becomes concerned, and has Foreman raise his right arm. Foreman raises his left.

House, MD Season 2 Episode 220: Euphoria Part 1

A cop named Joe Luria corners a young gang member in an alley. Joe giddily mocks the perp as he reads him his rights. The gang member pulls his gun and shoots. The bullet shatters against Joe’s flak jacket, with a piece deflecting up through Joe’s neck and into brain matter at the base of his skull. Joe lies on the ground, laughing as blood gushes from the wound.House and the team deduce the cause of Joe’s hysterical reaction. Chase thinks that the bullet fragments in the brain are to blame, but House points out that it is the wrong area to cause euphoria. They will need to expand their search, factoring in Joe’s cough and cloudy lungs.
Chase mentions carbon monoxide poisoning, which would explain the elevated heart rate, coughing and imp Aired neurological functions. House considers that the patient might have been exposed to CO indoors and went outdoors before collapsing. He orders an arterial blood gas test. In the meantime, they must check Joe’s squad car, personal car, precinct and home for gas leaks.
Chase finds low-level CO poisoning. He is about to slide Joe into the hyperbaric chamber when Joe’s fist suddenly clenches. As his brain struggles for oxygen, Joe loses motor function. That grim news can’t take away Joe’s giddiness. Yet when Cameron mentions that someone is checking Joe’s home for a gas leak, he immediately turns serious.
Foreman searches Joe’s incredibly filthy apartment for some clues. He swabs samples from the rank kitchen. Foreman then steps through the window onto the building’s roof and notices a shed with a power supply. He finds a hydroponic marijuana farm.
House goes to the precinct and hears a cop with a raspy cough. The man’s desk is right next to Joe’s, below the same air conditioning unit.
Back at the hospital, Foreman is convinced that marijuana is the explanation. House believes that Legionnaire’s disease is the cause, citing the rancid water in the AC unit as evidence. The next morning, Joe is feeling better, and Foreman observes that his COHb levels are down. Chase points out on the x-rays that the clouded area in the upper lung lobes are clearing up. Joe seems more concerned with making sure Foreman won’t reveal what was at his apartment. Suspecting something is wrong, Foreman spins around the portable light board and shows it to Joe, who agrees that the x-rays look fine. The doctors realize that Joe is blind.
Foreman reports that Joe’s papillary responses are intact, the fundus looks normal and there’s no macular degeneration. He thinks Joe has Anton’s Blindness, a condition in which patients can physically see but the brain cannot process the information. This indicates damage to both occipital lobes. A stroke is a possible explanation. House suspects a brain clot, but they can’t do an MRI because the bullet fragments will move and shred Joe’s brain. Cameron suggests an angio x-ray. Although House considers this a waste of time, the team badgers him into it.
Cameron explains to Joe that they will send a catheter through his femoral artery to his brain. Foreman remarks to him that he’ll be back on the streets scaring people. When the team reconvenes in the morgue with the results, Cameron presses House to remove Foreman from the case because he hates cops. Foreman says he was just having fun with a hypocrite, so House lets him stay. There is also the fact that Foreman is the team neurologist.
The angio shows some clotting, but not enough to be decisive. House again suggests an MRI, which Foreman again shoots down. House pulls out a gun and shoots a cadaver with an identical bullet. They can now run a test MRI to see how the bullet is affected. Cameron and Chase are shocked and scared, while Foreman is merely bemused.
Cameron continues to harp on Foreman’s behavior. House asks whether it was aggressive or giddy, noting that Foreman’s amusement at the gunshot isn’t a normal reaction. Foreman adamantly insists that being bored by House’s insanity isn’t proof of illness. With the cadaver in place, House flicks the switch on the MRI. The bullets are immediately ripped out of the skull and forever buried in the magnetic coils.
They learn that the MRI is out of commission for at least two weeks. Foreman wonders if doing nothing is their only option, seeing as how the giddiness seems to have disappeared. The blindness hasn’t, so House orders an echo of Joe’s heart to search for the source of the clots. They could get lucky.
As Cameron and Chase perform the ultrasound, Joe goes into tachycardia. They rush to save him, while Foreman merely stands back and giggles. Chase recognizes intracranial bleeding, forcing them to cut Joe’s temple to relieve the pressure. Foreman can’t stop laughing.
Foreman is sealed in an airtight bio-safety room with Joe and two nurses wearing full biohazard suits. He still insists that he’s fine, but House is more focused on finally getting a chance to use an MRI to locate the problem. They will use it on Foreman.
House draws his own blood sample and informs Chase and Cameron that anybody with an elevated SED rate is joining Foreman. He has noticed in the MRI an area of increased T2 attenuation in the cingulated cortex. This mushiness would explain the euphoria, but what explains the mushiness? House asks who wants to investigate Joe’s apartment next. Cameron turns to leave, but House stops her. Foreman brought back samples from the apartment. House was merely testing them.
Cameron sorts through the samples using protective gloves built into a protective steel case. At the same time, Chase tries to draw blood from Foreman. Foreman asks Chase what they’re thinking because he believes it might be a staph infection. If Chase delivers linezolid directly into their brains, Foreman and Joe can be cured.
The samples test negative for toluene, arsenic and lead, and the blood is negative for West Nile or Eastern equine diseases. Cameron wants to go to the apartment for more samples, but House refuses to allow it. He wants to take a sample from Joe’s brain, but surgery is impossible because he is on blood thinners. Using Foreman is the only option. Chase tries to resist with everything Foreman told him earlier. Yet House knows where Chase is getting this line of thought.
House heads down to the isolation chamber to talk to Foreman directly. House doubts that he has a staph infection because it would present in numerous different ways before a brain abscess. House offers Foreman a release to sign so he can biopsy his brain, but Foreman wants to see the MRI first. He insists that the mushy spot on the x-ray could have developed into an abscess by now. House mentions fever and Foreman’s reads 101.6. Foreman insists that House put an omaya reservoir into his skull and treat him for staph.
A neurosurgeon drills into Foreman’s skull, exposing his brain. Foreman, wide awake during the procedure, looks at flash cards for Chase and identifies the simple shapes on each one. Foreman then hears House’s voice coming from behind his head and realizes what’s going on. House is going to biopsy his brain. Foreman orders him to get out of his temporal lobe.
Foreman wakes in the middle of the night, back in the isolation room. Joe says he can’t see anything, and Foreman is encouraged by this because Joe is now aware of his blindness.
The biopsy shows non-specific signs of inflammation. Cameron quickly points out that House’s “can’t miss” idea stole a billion of Foreman’s brain cells, turning up nothing. Yet the biopsy was also negative for a staph infection. Cameron again asks to go into the apartment. House turns her down once more. They will instead retest the samples for any toxin, bacteria or fungus that attacks the brain. House orders Cameron to suit up to monitor Foreman for Anton’s Blindness. They need to track Foreman to see how far behind he is from Joe.
Wilson questions why House is being so cautious and avoiding Joe’s apartment. House doesn’t want to lose another doctor. Wilson realizes that Foreman is not simply another patient to House, no matter what he claims.
As Joe writhes in agony, Cameron tells Foreman they found nothing in his brain. Foreman suggests returning to the apartment because he might have missed something. The cause may be listeriosis. Cameron says that they cannot go back because of the danger. Foreman becomes angry. He picks up a syringe he used to draw his own blood and jabs Cameron in the leg. He says she can either tell House what happened or head to Joe’s apartment to save all three of them.
House and Chase stand outside the chamber as Foreman throws out possible diseases to them. Joe continues screaming in pain, so Foreman picks up a syringe and injects morphine into his IV. Chase yells that Joe is already at his daily limit and more could kill him. Realizing that the pain could cause a stress cardiomyopathy, House makes no attempt to stop Foreman. The screaming continues, and the doctors realize that Joe has a new symptom -- hyperalgesia. The infection has spread to the pain center of the brain, which is telling Joe that his entire body is in tremendous pain. No amount of medicine can soothe it. House tells Chase to suit up and induce Joe into a coma.
Foreman continues to throw out explanations to House, who wonders why Foreman isn’t concerned that Cameron is missing. When Foreman doesn’t react, House starts to figure out where she is.
Cameron samples Joe’s entire apartment, including his rooftop farm. As she is re-sealing the biohazard tape on the door, she turns and finds House. Cameron tells him about the needle, and House can’t believe she came to the apartment instead of killing him on the spot. Even by breaking the skin, the chances of infection were remote. Cameron wanted to be here.
House roots through Cameron’s samples. He’s disinterested by the normal garbage, but his curiosity is piqued by the inclusion of three loaves of rye bread. He sends Cameron back inside. Using his cell phone, he directs her out onto the roof with the bread in order to draw out pigeons. He instructs Cameron to look for pigeon droppings. She doesn’t find any, and House has her look for a dustpan because he figures Joe uses the droppings for fertilizer. She finds a used scraper on a bucket. The bucket full of pigeon droppings is the perfect home for Cryptococcus neoformans. Once that enters the brain, it causes happiness, blindness and intractable pain.
Cameron puts a sample of droppings onto a slide and adds GMS stain. She doesn’t get the result she was expecting and sprints upstairs. In the isolation room, Joe crashes. Cameron runs up and tells the team that the sample was negative for Cryptococcus. As the doctors suit up, Foreman shocks Joe with no results. A subsequent epi injection does nothing. Joe dies.

House, MD Season 2 Episode 219: House VS God

Charismatic 15-year old Boyd Mullins preaches to the congregation inside a storefront church. He places his hand on the forehead of an old woman with a walker, then pulls the walker away. With the crowd’s encouragement, the woman takes a few steps on her own. Boyd offers praise to the Lord, then collapses to the ground, clutching his stomach.
At the hospital, Foreman tells Boyd that he doesn’t have an intestinal blockage. Cameron draws blood and Boyd thanks her for the painless procedure. He claims that God told him she was kind. Boyd’s father, Walter, helpfully explains that God speaks to Boyd quite frequently. Cameron observes that Boyd’s urine is dilute, which could mean his kidneys aren’t functioning properly.
The team presents the case to House, who can’t get past the idea that God talks to Boyd. Chase tries to move things along with the report that the only medical issue showing up in the blood work is low sodium. Both Addison’s and cirrhosis tested negatively. House orders his staff to monitor Boyd’s saline intake. He wants to talk to this preacher boy himself.
House presses Boyd on issues of faith, but he holds his own with qualified responses. Noting that Boyd is lucid, House finds it curious that he is being treated in a hospital when his preaching keeps others from medical help.
Wilson meets with Grace, a terminal cancer patient. She’s losing the battle and seems resigned to it. Wilson assures her that the right combination of pain meds exists and that he will find it. House summons Wilson to the balcony and explains that Boyd merely watches people and deduces their problems. He then gives them advice that he claims God passed on to him. This is some kind of power trip. Wilson smirks at the similarities between Boyd and House. The boy’s symptoms are massive cramps and low sodium. House thinks he was probably drinking water nonstop since God told him to purify his body. The water intake would lead to low sodium, which would cause cramping. House wasn’t looking to Wilson for medical advice. He just wanted to rant about seemingly intelligent people believing in religion.
Boyd slowly shuffles through the halls singing a gospel hymn. He’s having a singing seizure which is a partial seizure in which people repeat lines from songs. Chase tries to lead him back to his room, but Boyd doesn’t respond. He stumbles across Grace, puts his hand on her head and says that all things are possible in faith. Boyd calls upon the Lord to heal her. Wilson intervenes and has Chase get Boyd back to his room.
House wonders if they should have Boyd ask God what’s wrong with him. Or else they should just do an MRI. Wilson barges in, enraged that they let Boyd roam the hallways and taunt Grace with false cures. She thinks she feels a little better but that’s just a placebo effect. It will be up to Wilson to pick her back up when it isn’t true.
House passes the whiteboard in his office and notices a little scoreboard putting the tally at “God 2, House 1.” Boyd comes in and notes the score. House quickly points out that the game isn’t over. Boyd wonders if God is in the lead because he healed Grace when she came back to his room. House counters that Boyd simply likes messing with people and giving them a rush. But when the endorphins wear off and the pain returns, Boyd is long gone. Boyd claims that doesn’t happen. House asks if he’s ever done studies on his track record. Boyd defensively claims that God told him it was so.
Boyd says that he can tell House looks for excuses to be alone. House dismisses this as a simple trick of deduction because of his gruff exterior. He asks Boyd for more specifics from God. Boyd says that God wants House to invite Dr. Wilson to his poker game. House stops in his tracks. Wilson does want to be a part of House’s game this week, but how did Boyd know the game even existed? House accosts Wilson, but he claims that he has never talked to Boyd beyond the encounter with Grace in the hallway.
Chase shows House the MRI images and points out a small, abnormal area. House declares it to be tuberous sclerosis. It certainly would explain all of the symptoms, including the chats with God. House gives himself one more point on the scoreboard.
Wilson tells Grace a story about a doctor that the Catholic church keeps at Lourdes. While thousands of cases say people claim to feel better, the Vatican recognizes only a handful of miracles. Grace insists that she likes the view that Boyd is providing. Wilson warns her about facing reality. He offers to take new images of her liver.
Foreman and Chase break the news about tuberous sclerosis to Walter and Boyd. The disease causes small tumors to grow throughout the body, and his are expanding. They will need to perform brain surgery to remove them. This will cure his chemical imbalance, the seizures and his auditory hallucinations.
Boyd refuses the surgery. House wants Cuddy to call the lawyers, but she wants him to talk to the patient first. Yet he must approach it not as an adversary, but more like Wilson does with his patients. House finds Wilson and asks him to speak with Boyd because Cuddy requested him to do so. Wilson only agrees to do it if House lets him in the poker game. House relents.
Wilson approaches Boyd to find out why he doesn’t want the tumors removed. The patient answers that God put them there for a reason. House can’t stand this, and he charges that God is everywhere and doesn’t need to send messages to Boyd’s brain. Boyd admits to Wilson that his visions have been blurry lately. Wilson points out that this means the tumors are growing and putting pressure on his optic nerve. He asks Boyd if he thinks God wants him to die. Walter replies that God gives the most trials to his chosen ones.
Wilson asks if Boyd thinks he is a saint because the one hallmark of a saint is humility. If he rejects surgery because he thinks he’s special, then he’s not a true saint. True humility would force a person to at least consider the possibility that he simply has an illness. Boyd is troubled by this logic. House then congratulates Wilson on his powers of manipulation. He also wants him to bring pretzels to poker night.
House is at home when Wilson stops by with some images of Grace’s cancer to prove that Boyd didn’t heal her. The images showed that Grace’s tumor has decreased in size. House is struck by the revelation, and he asks Wilson not to share this information with Boyd.
The next morning, House demands that Chase get him every single scrap of medical information that exists on Grace. She thinks Boyd saved her life. Cuddy mentions that Boyd and Walter have withdrawn permission for surgery, but she is putting the lawyers on it. She also has her doubts about Grace’s tumor. House thinks that the only way to save Boyd is to prove that Grace is still dying. The scoreboard now reads God 3, House 2.
The team pores over Grace’s records, searching for possible mistakes and mis-readings. Suspecting a delayed reaction from radiation, Chase scans Grace’s home with a radiation counter. All he finds are four kinds of pain pills and an experimental LED device that’s sold over the internet to stop pain. He calls House, who tells him to keep looking.
During poker night, House turns to Wilson and wonders how Boyd would have found out about their game. The only person he’s been talking to is Grace. Why would Wilson tell Grace about the game? Perhaps Grace is more than just a patient. House concludes that Wilson has been sleeping with Grace. Wilson has no response. They argue. Wilson says that it happened one night when her ride didn’t show up. House realizes that Wilson didn’t find an apartment of his own after all. He moved in with Grace.
House accuses Wilson of having a fetish for needy people. He needs to heal them. Wilson counters that House is only angry because he couldn’t tell that Wilson was hiding something. He hates Boyd because the boy is in more control than he is. This is also why religion annoys House. If it’s true, then House definitely has no control over his world.
At the hospital, Walter tells Foreman and Cameron that Boyd is checking out because God said he was fine. Walter pleads with them to talk to his son.
House gets a call that Boyd has contracted a fever and is delirious. Since tuberous sclerosis doesn’t cause fever, House and Wilson head to the hospital.
In front of the team, House declares that Boyd does have tuberous sclerosis, but it is only a mild case. They must perform an LP. Boyd resists, claiming that God told him not to use any more medical science. God will handle it. Foreman informs Walter that his son is delirious and that the decision is ultimately his. Boyd begs Walter to have faith. Walter tells the doctor that they don’t know what’s wrong with Boyd, but God does so it is in his hands. House tracks down Wilson for another speech to the family.
Wilson implores House to consider other solutions. The infection might be unrelated and he simply picked it up at the hospital. House reaches an epiphany. Boyd gave Grace a virus, which went on to attack her tumor. Researchers everywhere are experimenting with virii to fight cancer. Wilson thinks this theory is a reach and points out that the research virii have been genetically modified. House mentions herpes virii are most prone to attack cancer cells. Wilson realizes that herpes encephalitis would fit all of the symptoms.
House walks into Boyd’s room and orders him to strip. House is looking for the sores that are symptomatic of herpes encephalitis, mentioning to Walter that Boyd contracted it through sex. This would explain why he was guzzling water to purify his body. As Boyd begs his father to have faith, Walter instructs the boy to take off his clothes. He pulls down his pants, revealing a sore near his left hip.
A few days later, Boyd knocks on House’s door. Walter forced him to apologize. House walks over to his whiteboard, where the score is still 3-2. House asks Chase for his third point, knowing that Chase was running the scoreboard all along.

House, MD Season 2 Episode 218: Sleeping Dogs Lie

Hannah Ward lies in bed, unable to sleep, next to her girlfriend, Max. Hannah has had many sleepless nights. In the morning, Max finds Hannah in the bathroom next to an empty bottle of sleeping pills. Her eyes are wide open and she’s banging her head against the wall.Cuddy wakes House from a nap to inform him of Hannah’s case. He is disinterested until he learns that Hannah hasn’t slept in ten days. The brain shuts down without REM sleep. Five sleepless nights would bring on insanity with ten causing death. Cuddy points out that the longest anybody has ever survived without sleep is eleven days. On top of that, Hannah downed an entire bottle of sleeping pills with no effect. House is intrigued.
The team dismisses infection, schizophrenia and drugs as a root cause for Hannah’s sleeplessness. House wants them to consider optic nerve disease because sleep is initially controlled by external light cues. Hannah’s brain might not be able to interpret or receive those clues due to an optic problem.
In a soundproof sleep lab, Cameron photographs Hannah’s retina and optic nerve. Foreman notices that Hannah has fallen asleep. Her EEG shows normal, stage one brain waves. Then Hannah quickly wakes up.
Foreman reports to House that the tests for optic nerve disease and ocular pressure proved negative. Hannah slept, but only for up to one minute. A CT showed no tumors, clots or seizure disorder. Hannah sleeps but cannot remain asleep. House figures that Hannah is sick but not sick enough to present symptoms. He orders the team to keep her awake at all times. Depriving her of the few minutes she does sleep will stress her body. This will help them determine what’s afflicting her.
Cameron and Foreman take the first shift, waking up Hannah when she drifts off. Each time, she denies falling asleep. Then they notice a pool of blood on the bed sheets. House thinks the rectal bleeding is either a clotting disorder or colon tumor, so Chase heads off to perform a colonoscopy. House makes it clear that Hannah needs to be kept awake through the procedure. She will not be given sedatives unless a tumor is found.
Hannah screams and strains as Chase performs the colonoscopy. Blood begins to drain from her nostrils as she struggles to breathe. Cameron reports that the rectal exam showed traces of nasal matters. Was a massive sinus hemorrhage draining down her throat and out the back? House thinks about the poison ivy that was noted in Hannah’s recent history. The rash developed around the same time as the insomnia. A rash plus sleep disturbances equals Wegener’s Granulomatosis. House orders a large dose of corticosteroid treatment and an upper airway biopsy to confirm Wegener’s.
Chase performs the biopsy when Hannah’s eyes start to dart about. She is experiencing REM with her eyes wide open. She then quickly snaps out of it. House rules out REM, dismissing it as a movement. This also rules out Wegener’s. Chase throws out the notion of allergies because Max got Hannah a dog about a month ago but sent it back when Hannah was allergic. House seriously doubts it because the poison ivy treatment should have suppressed any allergic reaction. He thinks Hannah was lying about being allergic. A dog is a commitment and she intended to break up with Max. He agrees to check for allergies.
During the test, Cameron inquires about Hannah’s relationship status. While Max is out of the room, Hannah admits that she was going to end their long-term relationship. Hannah then complains of a pain. Cameron rolls her over and is shocked to discover the woman’s entire abdomen covered with dark bruises. The team struggles to come up with new explanations for Hannah’s massive internal bleeding. Foreman reports that Hannah’s liver is dead. She needs a transplant and they only have six hours to determine what’s affecting her. House points out that Max donated blood to Hannah, so they must be a match. Cameron can’t imagine asking somebody who’s about to be dumped for half of her liver.
House tells Hannah that she’s in acute liver failure and will lapse into a coma in a few hours. Max can’t believe they’re just giving up, but House says even with a new liver, toxins will continue to build. Max, however, realizes that a new liver will allow the doctors more time to make a diagnosis. She pushes House to go forward with the transplant. House successfully manipulated the situation.
They now have another 36 hours to diagnose the patient. House, however, did not tell Max that Hannah is planning to dump her. As the team searches for causes, Cameron frets that they are ignoring an ethical dilemma. House quickly tires of her questions and shouts that if they tell Max and she changes her mind, then Hannah will die. Foreman and Chase continue throwing out possible explanations. House tells the team to put Hannah through a battery of tests that. He threatens to fire anyone who tells Max about Hannah’s intentions.
Without sharing too many details, House consults Cuddy about the conflicting interests between Hannah and Max. She wants to know what he is hiding. He explains that the two options are for her to satisfy her curiosity or remain ignorant and help keep Hannah alive. Cuddy begins taking Max through the detailed steps of a transplant. Max is vigilant about going through with the procedure.
Cameron begins performing an endoscopy on Hannah, which entails a long tube inserted down her throat to swab her stomach for mushroom spores. While sliding the tube, Cameron begins to lay the guilt on Hannah. Max is undergoing painful procedures and will risk her life with the transplant. If Hannah truly loved her, she would tell her the truth. Hannah knows that if she tells Max, she dies.
Max gets clearance for surgery. Foreman and Chase report that tests were negative for Wilson’s Disease. House realizes that if those are two are here with him, then Cameron is alone with Hannah and Max. Cameron rolls Hannah’s gurney next to Max and leaves them alone for a moment. As Hannah is about to confess to Max, House interrupts. He orders the surgeons to get started.
Max’s heart stops during the transplant operation. House pulls Cameron away from observation to focus on Hannah, who is in recovery. The surgeons shock Max back to life. Wilson joins the team to discuss Hannah’s situation. Wilson points out that the immunosuppressants they have Hannah on would hide any possible cancer diagnoses. House is aware that they need to retreat. They will stop the immunosuppressant drugs in order to retest Hannah.
Hannah starts to reject her new liver. House is not surprised, but her normal white count is odd because it should be very low. Foreman suggests an infection. The team rapidly fires out a long list of infections, shooting each one down for various reasons. Typhoid fever seems to fit, but Hannah hasn’t been abroad. House begins to think about the dog that Max brought home. He asks Cameron where the breeder is located.
House takes his team to Hannah’s room. He immediately goes for her upper arm, where he finds a grotesque growth. Using a syringe, he withdraws a thick, black ooze and hands the syringe to Chase. House tells Chase to inform the CDC that they have a patient with the plague. He then explains to his confused team that the Blue Barrel Kennel, where the dog came from, is located in the Southwest. Fleas in that area occasionally carry the plague. A small percentage of plague cases present with severe sleep disturbance. House orders Hannah started on large doses of streptomycin sulfate, gentamicin and tetracycline.After a few days, Cameron finds Max in the hallway and stops for a chat. Max admits to Cameron that she knew that Hannah was going to leave her. Hannah told a friend and the friend let it slip. Cameron is shocked that Max knew the truth and still went through with the transplant. Max smiles and says there’s no way that Hannah can leave her now.

House, MD Season 2 Episode 217: All In

Young Ian Alston learns to ride a bicycle. When his father picks him up off the bike, he finds blood all over the back of boy’s pants.House, Wilson and Cuddy play poker at a Casino Night fundraiser for the hospital. A doctor alerts Cuddy that Ian is in the ER. The boy has bloody diarrhea, and although he is hemodynamically stable at the moment, he is developing coordination problems. Cuddy orders some fluids and says she’ll check on him during her rounds. House asks about the heart rate and inquires if a head scan has been done. Cuddy just wants to focus on the cards, but House quits the game to go check on the boy.
In the ER, I an has no problem following House’s finger with his eyes. House then asks Ian to grab his cane, and Ian struggles to grasp it. House tells the Alstons that Ian’s brain is losing control of his muscles. House goes back to the benefit to grab Chase. He wants the others to meet him upstairs.
House tells the team that there are two cases with identical symptoms, but one patient is six years old and the other is over seventy. He explains that many years ago he had a 73-year old female patient with this exact progression of symptoms, but she died before he could solve the case. Ian already has bloody diarrhea and ataxia. The previous patient, Esther, progressed from there to kidney failure in only 80 minutes. She died in less than a day.
The team is skeptical, figuring that Ian merely has food poisoning. House considers Erdheim-Chester, a disease that Chase mentions has only been recorded 200 times in history. House thinks he could have found case number 201 had Esther’s family allowed an autopsy. He orders a colonoscopy for Ian. Cameron explains to the parents that Erdheim-Chester is an abnormal growth of some of the cells that fight infection. During the colonscopy, Foreman thinks they’ve found the purple papules that House was looking for. Chase is skeptical, figuring House is merely obsessed with a patient he lost long ago.
The papules are biopsied, but come up negative for Erdheim-Chester. House then requests a kidney biopsy. He examines the urine bag attached to the boy. The liquid is brown, which means Ian’s kidneys are shutting down. Ian is reaching Esther’s third symptom.
The team reconvenes to figure out the symptoms. Chase suggests E. Coli, but House points out he tried that last time. Cameron throws out lymphoma. House agrees that this is a possibility and asks for a blood smear and an MRI. They want to alert Cuddy that her original theory of gastroenteritis is not the cause, but House would rather not tell her anything in case she disagrees and interferes. House calls Wilson at the tables and asks him to keep Cuddy occupied.
The MRI shows that the base of Ian’s brain has been infiltrated by a small mass, likely related to the pituitary. Pituitary failure was the fourth of Esther’s symptoms. It also somewhat confirms lymphoma, although none of them actually saw it. The blood fact offers a contrary diagnosis. House walks out of the office.
The team finds him breaking into the commissary to get some coffee. He says that the next stop in the disease’s progression is the liver. Growing frustrated, House orders the team to give Ian every drug they can think of that will protect the liver.
Chase informs House that the liver is holding, but Ian’s platelets are dropping. Oddly, House is encouraged. This is a new symptom, different from anything Esther experienced. Ian begins gasping for breath as Foreman and Chase rush to help him.
House writes respiratory distress on the white board under Ian’s symptoms. Respiratory failure was the last of Esther’s symptoms before death. Feeling hopeless, House pushes the white board over. With Ian now on a ventilator, the team again tries to analyze the progression of symptoms. Ian is moving even faster than Esther did. Cameron tosses out that the interferon they put Ian on could possibly affect a type of leukemia. House calls Wilson for advice. Wilson comes upstairs to examine Ian’s blood, but doesn’t see anything askew.
Wilson suggests Kawasaki’s disease, in which antibodies eat the inside of the arteries, slowly choking off blood to major organs. Intrigued by the possibility, House prepares to search Ian’s coronary arteries for the disease, but the arteries are clear of aneurysms and the blood flow is normal. As he is about to shut down the scan, Chase notices a mass in Ian’s right atrial valve. House immediately readies to perform a biopsy.
During the procedure, Ian goes into cardiac arrest. It takes repeated attempts, but House is able to shock the boy back to life. House goes back to the biopsy, which Chase thinks is reckless after eight minutes of arrest.
Back in the office, the team begins throwing other possible diseases against the wall. Cuddy, having been alerted to Ian’s plight by the Alstons, barges into House’s office and angrily accuses him of giving the young boy brain damage. She thinks he’s still obsessed with Esther’s case twelve years later. She orders him to stay away from Ian. When Cuddy leaves, House plows ahead anyway. He hands Cameron the piece of mass they extracted and asks how many tests they can complete. She thinks they can do three, even though there are seven potential diseases on their board. They elect to start with histiocytosis, figuring Cuddy will be smart enough to test for sarcoidosis on her own.
The test for histiocytosis is negative, so they turn back to the board. House opts to test for tubular sclerosis, mainly because the test for that is more reliable. Sclerosis also comes up negative. House is now stumped. He stands on his office balcony, lost in thought. Wilson comes out to report how he triumphed in the poker tournament by hiding his pocket aces. The story leads House to an epiphany about what else could have been hiding.
House realizes that when they tested for Erdheim-Chester earlier, it hadn’t progressed far enough. He wants to use the last available piece of mass to test for it again. This time, the test confirms the ultra-rare disease. The team immediately starts the proper treatment.

House, MD Season 2 Episode 216: Safe

Teenage Dan shows up at his girlfriend Melinda’s house. Melinda’s mother Barbara makes Dan scrub up before being allowed in her daughter’s bedroom. Melinda, who just received a transplant, complains to him about her crazy mother not letting her out of the house anymore. Dan and Melinda kiss, but hives breakout on her skin. Melinda begins to gasp for air and she swells up. Barbara quickly injects her with a shot of epinephrine for allergy attacks. She then accuses Dan of doing something wrong.
At their apartment, Wilson tells House that Cuddy called about a girl in anaphylactic shock. House would rather talk about their new living arrangement, but Wilson piques his interest. Although the girl is immuno-compromised, the attack happened while she was in a clean room.
The team is confused by Melinda’s case. A person who received a transplant six months ago shouldn’t need a clean room. The team settles on one of three lies. Either the boyfriend brought something in and is lying about it or the girl snuck out and is lying about it. The room might also not be hypoallergenic and the parents are lying about it. House orders a recheck of all parties and the room.
Foreman quizzes the family on their recent history. He doesn’t see any reason for Melinda to stay home. Barbara pulls Foreman into the hall and explains that allergic reactions have almost killed Melinda four times already. Once it caused her to lose control while driving, which is what lead to the heart transplant. Barbara feels she’s not protective enough.
Cameron and Chase examine Melinda’s bedroom. One window isn’t rigged to the home alarm system, and a nearby tree provides easy access. Was Dan doing some nocturnal climbing? At the hospital, Dan admits to Chase and Cameron that he snuck in Friday night and they had unplanned, unprotected sex. The doctors ask him for a semen sample so they can check Melinda for a semen allergy.
The test proves that she isn’t allergic. Cameron assumes that Dan took every precaution before their encounter, but House wants facts. He pulls Dan out of Melinda’s room and interrogates him on whether he has been taking antibiotics or penicillin. Dan admits that a friend’s dad had some leftover penicillin, so Dan took it to prevent exposing Melinda to anything. He had no idea that she could have been allergic to penicillin or that he could have spread it to her through his sperm.
Cameron and Chase break the news to Barbara that Melinda is being released. Yet they don’t tell her the specifics of this latest attack. Suddenly, Melinda begins gasping for breath and she vomits. Cameron realizes that this isn’t an allergic attack. It is Melinda’s heart.
The team reconvenes, now looking at congestive heart failure and anaphylactic shock which are two puzzle pieces from two different puzzles. Cameron suggests that the first episode wasn’t anaphylaxsis but cyclosporine toxicity. House seems skeptical, and Foreman wonders what if it actually is two separate, totally unrelated incidents. House can’t see how the two would be tied together, but Foreman presses to only look for a heart failure cause.
Foreman and Cameron perform a CT scan, but find no sign of coronary disease. Then they run blood work to rule out infections and a biopsy to rule out rejections. Melinda begins to worry that she’s going to lose this heart. She knows the transplant only gives her five to ten more years, and she begs Foreman to convince her mother to allow her to enjoy the time she has left.
While at the apartment, House asks Wilson if he can think of anything that would tie together anaphylaxsis and heart failure. He questions if it is even possible for anaphylaxsis to not be anaphylaxsis, even if it responds to epinephrine. Wilson is too aggravated by House as a roommate to think of an answer.
The blood work and biopsy both come back negative. Foreman and the parents head back to Melinda’s room but it is empty. Cuddy calls in a security alert. Noticing that Melinda left her clothes behind, they figure she must still be in the building. Foreman thinks she wants to be outside, and he races for the roof. He finds Melinda on the top stair. She complains that her mother is completely overbearing. Foreman patiently explains that she just had heart failure. Melinda cries that this all means that her mother was right all along. As they begin to walk back downstairs, Foreman notices that the girl has an odd gait.
Foreman examines Melinda in front of her parents. The steppage gait is a sign of extreme weakness or partial paralysis. Foreman then sees twitching above Melinda’s knee and informs the family that it’s fasciculation, which means that the paralysis is ascending.
With the paralysis ascending at this rate, the team knows it will Melinda’s lungs in a few days. House wants to tie together the heart, anaphylaxsis and paralysis, but Foreman wants to focus on the paralysis first, since that’s what will kill Melinda in the short run. He suggests Guillain-Barre based on the speed of advancement. House agrees with Foreman’s line of thinking and orders an LP and an EMG.
The tests, which ruled out polio and West Nile virus, seem to point to Guillain-Barre, a disease in which the immune response goes haywire and begins attacking the peripheral nerves. Fortunately, it usually responds well to plasmapheresis. They begin the treatment.
The first treatment is ineffective. Melinda begins to sink into depression. Foreman explains to Barbara that mood swings are common with the medications, but Barbara believes that her daughter has finally given up. Melinda again begins gasping for breath. Chase quickly determines that it is not an allergy attack. Foreman, realizing the paralysis has reached Melinda’s lungs, intubates.
Chase and Foreman call House. The paralysis is moving too fast to be Guillain-Barre. Cuddy wants an MRI to rule out a spinal lesion. The team reconvenes, searching for a new explanation. What if the boyfriend snuck in some food during the tryst and she developed botulism? House asks the team to inject a rat with Melinda’s blood. If it develops botulism, their theory will be confirmed. Meanwhile, House is heading downstairs to browbeat Melinda into admitting whatever she’s been hiding.
As Cuddy slides Melinda into a CT scan, House and Foreman interrupt. House accosts Melinda about the night Dan snuck in. He explains that Dan’s penicillin caused her anaphylactic shock. Yet Melinda tells House that Dan actually took clindamycin, the same medicine that she uses. She saw the bottle. House and Foreman immediately realize this means the anaphylaxsis is still unexplained. Everything is connected.
When Melinda says that Dan hopped the fence before climbing, House says Dan must’ve dragged a tick in with him. House combs Melinda’s body to look for it. Foreman reminds him that they checked for insect bites earlier and Cuddy scoffs at House’s line of thinking. Melinda drops into heart failure. Foreman administers atropine. Cuddy calls for a bag of dopamine, then orders House and his tick search out of the room. Wilson says they have to get Melinda up to the ICU.
Wilson and Foreman wheel Melinda into an elevator. House blocks Cuddy from entering, then stops to elevator to continue his tick mission. Foreman hooks up one more bag of atropine, which buys House three more minutes. Melinda’s heart rate drops to 56.
Cuddy and Melinda’s parents race upstairs, only to find out that the elevator has been stopped. Cuddy angrily tries to cover. Inside the elevator, House is still adamant about the tick as Melinda’s heart rate drops to 45. Foreman restarts the elevator. House thinks of one last place to check, and finds the tick in her vagina. The elevator doors open, and House holds the tick as Melinda stabilizes.

House, MD Season 2 Episode 215: Clueless

Maria Palko steps out of the shower and finds a masked man in her bathroom. The man drags Maria to her bed and she fights him off. The man begins struggling to breathe. Maria calls an ambulance for the man, who is actually her husband Bob. Their rape fantasy had an unexpected end.
Another interesting couple prepares for the day. Wilson is staying at House’s apartment during his separation. House is bothered by Wilson’s habits, and he orders him out only one night. Wilson promises to be moved by the next day.
At the hospital, Bob explains to Cameron that he has dry throat and a feeling that his tongue is swelling. Two previous doctors tested him for food allergies before referring him to House. The Palkos are remarkably open about their sex life during the examination. They reveal that they recently had a threesome with Maria’s old college roommate. House wonders if the problem is actually in Bob’s lungs. He orders more blood drawn, a chest VT and a body plethysmograph.
Bob sits inside an egg-shaped body pod, holding a tube in his mouth. Maria watched while Cameron runs the test. Their conversation turns to the couple’s unusual sex life. Maria defends the effort, saying that marriages fail because people don’t want to change.
The team reports that House was correct in the lung diagnosis. The plethysmograph revealed decreased lung capacity and the CT showed lung scarring. The team is convinced that Bob has interstitial pulmonary fibrosis. However, with all common reasons are ruled out, they don’t know the cause. Since Bob’s condition is currently stable, House wants to wait until the cause presents itself in another fashion.
Suddenly, bright red patches of skin emerge on Bob’s chest. The team reconvenes to figure out what causes itchy splotches and lung scarring. Foreman suggests lupus. House is hit with the realization that heavy metal toxicity might be the problem. House orders the team to search the Palko house. They also need to test Bob’s hair for lead, mercury and arsenic. Perhaps the Mexican resort that Bob and Maria vacationed at cooks with such metals. Maybe they recently repainted or made plumbing repairs.
At home that night, House asks Wilson if he thinks somebody could suffer lung damage after eating out of a pot painted with lead paint. Wilson replies that it would require months of daily eating.
Foreman searches the fastidious Palko house and finds an ant. House wants to know what type of ant. When Foreman tells him it was medium and brown, House rules out poisonous ants. A tox screen also disqualifies lead, mercury or arsenic, but House wants the tests run again. The team begins to resist House’s thoughts on heavy metals. He orders treatment for lead poisoning.
Chase is performing a scratch test on Bob’s back when he patient begins agonizing over a burning pain in his feet. This rules out food allergies. House thinks this is another sign of heavy metals, but Cameron insists that another hair and blood test ruled out any possible exposure. The team is paged to Bob’s room. He again struggles to breathe. They attempt to intubate, but Bob begins coughing up vomit. There is too much to be suctioned off, so the team is forced to perform a tracheotomy to help him breathe.
Foreman reports that Bob’s urine has elevated proteins and red blood cells. He stands by his theory of lupus, and House insists that the cause is a heavy metal. Foreman wants to run an ANA but House points out that they’ve already treated for lupus with no results. Unless House can prove his metal idea, Foreman plans to start a new treatment for lupus.
House considers whether Maria is poisoning her husband. He wants Cameron to search Maria, but she objects. House decides to do it himself. He corners Maria and tells her his suspicions. He searches her purse and asks for permission to examine her vagina because it is the only place she could be hiding something since she hasn’t left the hospital. Maria, Cameron and Cuddy all refuse to allow the search.
Foreman wheels Bob into an isolation room and the patient immediately seizes. Foreman races into the hallway for the crash cart and shocks Bob back to life. As House and Wilson observe Maria’s concern for her husband, House begins to doubt his theory on poisoning.
The team reconvenes in the office. Foreman is confident that what’s happening to Bob is the definition of lupus. Chase suggests a different treatment, and House mentions interferon, which treats neither lupus nor heavy metal toxicity. Yet House thinks it’s about all they can do right now for a viral infection. House says the lupus treatment has wiped out Bob’s immune system which is what invited the current viral infection. Foreman points out that interferon will make lupus even worse. House strongly orders interferon.
That night, Bob and Maria are alone in the isolation room. Bob tells her that he sat behind in her high school to cheat off her during a test. They’ve had a long history and he loves her. Maria refuses to say she loves him because he’s not dying, and she doesn’t want to say goodbye. After a moment, she gives in and says it.
The next morning, Foreman tells House that the interferon isn’t working. House wants an increased dosage. Yet tests for every virus they can think of are all coming up negative. House repeats his instructions to up the dosage. Later, House looks at a gold wedding band and has another epiphany. He calls Cameron and asks if Maria has a family history of arthritis. When Cameron confirms this, House orders Cameron to stop the interferon, run a heavy metal screen for gold and prevent Maria from using the bathroom.
The doctors are stunned as they read the results of the tox screen. House, meanwhile, races home and pulls a wooden box from underneath his bed. House searches through a selection of small glass vials in the box until he finds the one he’s after. At the hospital, the doctors are trying to prevent Maria from using the bathroom. House arrives, looking for Maria. When he founds out she’s heading for the bathroom, House barges into the ladies room in search of her.
He finds her coming out of a stall and grabs her hands. House says that the damage to Bob’s lungs is permanent, but the coma and kidney damage are reversible. He should also regain all neurological functioning. Despite Maria’s complete confusion, House continues. He says that nitric acid, mixed with gold, turns bright purple. Maria’s hands are stained purple. House accuses Maria of sprinkling Bob’s food with gold sodium thiomalate, an arthritis remedy that’s out of date in the U.S. but still popular in Mexico. Maria denies it, but Chase reports that the tox screen for gold was off the charts.
Two police officers walk Maria out of the hospital in handcuffs. Cameron reports that they have started chelation therapy, but Bob will need a lung transplant. House doesn’t mind. He’s too pleased at having been proven right once again.

House, MD Season 2 Episode 214: Sex Kills

Henry Arrington plays bridge with his friends when his daughter Amy gets up because she feels nauseous. Henry goes to help her but stops as electrical signals flash wildly in his brain. He stands still, maintaining an iron grip on Amy’s arm. Moments later, he becomes conscious but is completely unaware of what just happened.
At the hospital, Foreman explains to Henry that he had an absence seizure. Foreman inquires about his recent history, but there is nothing out of the ordinary. Henry asks Amy to get him some coffee from the cafeteria. When she leaves, Henry shows Foreman something.
Foreman reports to the group that Henry’s right testicle is twice the size of his left. Chase assumes it is testicular cancer, but House disagrees. Henry’s MRI is clean. House points to a micro-abscess in the brain, which Foreman dismisses as a shadow. House thinks it could be an infection and he orders treatment for syphilis, gonorrhea and Chlamydia despite the fact that tests for all three already proved negative.
With the team perplexed, House explains that it could be lymphoma. Yet if it has already advanced to his brain and genitals, then it is too late. They can only treat for sexually transmitted diseases and hope that’s all there is. When Foreman tells Henry that they suspect an STD, Henry claims he hasn’t had sex since his divorce. He sticks to this story.
House thinks Henry is lying. He wants Foreman to interrogate him again after his daughter has left the room. Henry later explains that he couldn’t admit the truth in front of Amy because he slept with her mother. His ex-wife had two affairs and Henry forgave her both times. Amy blames Henry for being an idiot and taking her back. Henry begins laughing, which causes him to cough up bloody foam. House calls for the crash cart as Henry struggles to breathe. It’s definitely not an STD.
Chase points out that the problem is in Henry’s heart, with vegetations obstructing the mitral valve. However, lymphoma wouldn’t erupt so suddenly. House circles “acid reflux” on the white board. Henry mentioned that he had reconnected with his wife at a cheese tasting party.
House asks Henry about the cheese at the party and whether it was soft or sheep cheese. He feeds Henry a piece of cheese. Henry says it tastes similar to the one he had, and House reveals that it is regular American cheese with bacteria in it. Bacteria present in unpasteurized cheese can cause brucellosis. The antacid Henry was taking for acid reflux made his digestive tract an inviting environment for the bacteria. House starts him on a prescription of rifampin and doxycycline.
House admits to Wilson that, if he’s right about the bacteria but didn’t catch it in time, Henry will lapse into cardiac arrest. Henry does, and Chase shocks him back to life. He is able to restart the heart but not without significant damage. The patient did suffer from brucellosis but a vegetation broke off into his main coronary. Foreman gives him one week to live. With healthy brain and testicles, Henry now only needs a heart transplant.
House goes before the transplant board to plead Henry’s case. The board is concerned about Henry’s advanced age and they deny him the organ. Foreman breaks the bad news to Henry. Cameron comes to House with a letter of appeal she’s writing to the board. Although House actually agrees with the ruling, he signs the letter anyway.
Cameron later comes back to House with patient files because she is searching for potential donors. The only possibility is a woman in her forties named Laura who was in a recent car accident. Yet Laura is still technically alive. She’s also overweight, which means her heart isn’t in the best condition. House considers this as being in their favor. Since most hearts with imperfections are thrown out, House may be able to salvage this one.
After Laura is pronounced dead, House sneakily reads her file. Laura’s organs were declared not viable, and House prepares to search the trash. Foreman chases him down to tell him that Laura had hepatitis C. An infected heart will kill Henry in his condition. House doesn’t believe it.
Laura’s husband Donald gives the signal to take his wife off life support. House turns the machine back on because he wants to talk about the heart some more. House passionately makes his case to Cuddy. Even though Laura’s heart was rejected, House can find a team to pull the surgery off. Donald angrily rejects House’s pleas. As Donald storms out, Amy catches him in the hallway and thanks him for the heart he is giving to her father. Donald begins to crack, but when he sees House, his resolve stands. House would rather have Donald mad at him instead of the girl. Donald punches House in the groin as hard as he can. He tells Amy that he will donate his wife’s heart to Henry.
The team tries to talk House out of the procedure because Laura’s heart is too damaged. House intends to cure Laura’s problems first before using the heart. They run through various diagnoses on the symptoms. A sonogram on the body reveals a cyst, which rules out hep C. An amoeba infection might explain everything. House orders massive doses of paromycin and chloroquine, twenty times the usual amount.
Chase informs House that Laura’s heartbeat is irregular, possibly from global hypokinesis. House orders the meds stopped. Either they’re wrong and her heart is unusable, or the treatment they need to give will make the heart unusable. House apologizes to Donald and says he can pull the plug. Donald refuses. He thinks House must be an amazing doctor because nobody who’s that big of a jerk would be employed. Donald presses House to look for something missed. He has to save Henry.
The team looks for alternate theories. Chase notes that their amoeba theory is proved by Laura’s heart rate returning to normal when they stopped the meds. Cameron wonders if it is toxins instead of an infection. House orders another tox screen and sends the team out to search Laura’s environment.
Back at the hospital, the blood flow to Henry’s brain begins dropping. Chase inserts a balloon to assist the flow. At Laura’s home, House finds a bottle of diet pills. Cameron acquired photos of nude teenage boys at the school where Laura worked. Her school principal assumed Laura confiscated them from students. House wonders if she was having sex with the boys. What if the cyst was actual a scar from gonorrhea? House orders ceftriaxone as a treatment.
Laura tests positive for gonorrhea. Cameron starts the meds, which should clear up the heart in four to five hours. Chase alerts them that Henry has fallen into a coma. They must do the transplant now or Henry loses his brain from a lack of blood flow. House makes the call to the transplant team.
As Donald observes the procedure, Cameron prepares to tell him about the gonorrhea. Yet Donald breaks down and confesses to a one-night stand where he contracted gonorrhea. He didn’t admit it earlier because he thinks he gave it to Laura, which made her sick and caused the accident.
As Henry awakes after the surgery, Chase tells him that he will have a case of gonorrhea in his system for a time, but he’ll be fine in the long run.

House, MD Season 2 Episode 213: Skin Deep

Fifteen year-old model Alexandra Simms waits impatiently backstage at a fashion show. Her manager father, Martin, hands her a pill to steady her nerves. She washes it down with a glass of champagne. On the runway, Alex starts seeing double and stumbles. When another model asks her if she is fine, Alex punches the girl. Chaos ensues and Alex collapses in the mess.
House limps through the hospital, struggling more than usual with his leg. Wilson thinks the increased pain could actually be good sign that his nerves are regenerating. House brushes off his optimism. Cuddy approaches with a new patient file. A teen model has sudden aggressive behavior and cataplexy.
House drops into Alex’s room. The cataplexy checks out with Alex’s story, and House asks about sweats and other recent ailments. She claims to have been nauseous lately. Cameron waits in the hallway to grill House about his newfound interaction with patients. He orders her to do the tests and tox screen.
The tox screen reveals Valium and heroin in Alex’s urine. Cameron notes that a positive test doesn’t mean Alex is an addict. Chase wonders whether this is related to the fact that Alex has yet to menstruate. They also consider bulimia and the patient’s newly developed breasts. During the brainstorming, House’s leg buckles and he nearly falls. Even with addiction, Alex’s symptoms could be neurological, which points to juvenile MS or Parkinson’s. House orders a detox program at super speed. He wants them to put Alex in a coma and pump her full of naltrexone, which cuts the detoxification procedure from four weeks to one night.
Foreman explains the procedure to Martin, who agrees despite the risks. Chase and Foreman prepare to put an incredibly nervous Alex into an induced coma. Alex’s heart rate dips below 30 before flat lining. Nurses rush in and go to work on the girl. Martin finds House and demands that he pull Alex out of the coma. House explains that this option is even worse. The must see the procedure through.
Alex regains consciousness from her coma. She tells Chase that she feels fine. Alex tearfully apologizes to her father for using drugs. Chase begins to hook up a potassium IV, and Alex repeats what she just said. Back in the office, Foreman reports anterograde amnesia and short term memory loss which is evidence of a hypoxic brain injury. Foreman blames House for pushing the rapid detox. House points out that Alex would have to flatline for longer than she did for hypoxia to kick in.
House suggests that Alex suffers from post-traumatic stress disorder. She looks too good to be a heroin addict. With Daddy constantly by her side, House thinks Martin is either a very good father or a very bad one. He suspects sexual abuse, and orders an MRI and LP. If Alex’s brain comes back normal, House will have his proof. Out in the hallway, Foreman accuses House of letting his increasing leg pain influence his judgment. He’s trying to rush through this case. House turns and loudly asks Martin if he’s molesting his own daughter.
Alex goes through the MRI. Yet she has an involuntary shoulder twitch which will mar the MRI. Cameron thinks they should skip right to the LP. Slipping into a men’s room for privacy, House continues pressing Martin. He denies abusing his daughter. House asks if Martin loves Alex enough to admit what he did, since psychological conditions can manifest into physical problems. Martin confesses that it happened once.
House finds Cameron and Chase in the lab and happily reports that he was right. It is now time to move Alex onto a psych referral. Chase shows House the results of the LP, which show elevated proteins in Alex’s CSF. It wasn’t hypoxia and it wasn’t even the sexual abuse.
Cameron presses House to report Martin to child services, but House wants to finish the case first. Foreman starts running down the list of problems that would cause elevated proteins in the CSF: viral encephalitis, CNSV, Creutzfeldt-Jakob disease. House thinks they need to skip straight to a brain biopsy. The team is hesitant because this is too rash, but House is convinced that it is the only thing they have time for. They must perform a burr hole biopsy to remove a small section of brain tissue.
Wilson tells House that he heard about Alex flat lining. He wonders if the leg is affecting his judgment. House quietly confesses that he needs Wilson’s help. Meanwhile, Cameron goes to Cuddy about House not reporting Martin.
The biopsy gets underway while Wilson performs an MRI on House. Cuddy barges in, demanding to know about Martin. If House doesn’t turn Martin in, he’s fired. Wilson gives House the results that his MRI looks the same as it did two years ago. It might be psychological pain manifesting itself as physical pain, caused by House’s misery over driving Stacy away. House refuses to accept this.
The biopsy on Alex shows that she does not have a white matter disease. That leaves grey matter, which uncorks a range of possibilities which can’t be tested. House asks if what they are seeing could merely be smoke signals from a tumor. If Alex had cancer anywhere in her body, she could have paraneoplastic syndrome which would cause antibodies to attack her brain. Foreman counters that this is rare in a 15 year old, but House points out this is no ordinary teen. What’s more, it explains everything.
House squeezes an IV line on Alex and she immediately starts twitching. When he releases it, she stops. House explains that IVIG vacuums her blood and neutralizes the stuff that makes her twitch. Although Martin and Alex are excited by the development, House explains that merely proves that she has cancer.
That night, House asks Cuddy for a favor. He wants a shot of morphine in his spine. She refuses and tells him to take a Vicodin because morphine is too extreme. Desperate, House pulls down his pants and exposes his scarred and mangled leg. His skin has been indented by the lack of muscle. Cuddy agrees to the shot.
Alex receives an MRI, a mammogram and a bone marrow biopsy among other tests. Wilson can’t find any cancer but House insists that he is wrong because nothing else could explain the IVIG. Wilson is adamant that she does not have cancer. House retreats to his team and asks for a differential diagnosis. Chase wonders if the protein level was an anomaly. It might really be the post-traumatic stress disorder from Martin’s molestation. Alex saw House fiddle with the IV line so it could all be in her subconscious. House tells Chase to change Alex’s IV, but don’t inform her that he is replacing it with saline. They will see if the twitching returns.
As the doctors wait, a social worker from Child Services interviews Alex. The social worker exits and informs the doctors that no charges will be pressed because Martin denies telling House. Alex says that nothing happened. Cameron goes into the room and tries to convince Alex to tell the truth. Alex doesn’t go back on her statement. When Cameron presses, Alex admits that she seduced Martin and got him drunk because she wanted to have sex with him. She also slept with her photographer, her financial manager and her tutor. It’s the only way to get what she wants. The twitching returns.
House asks Cameron, who performed Alex’s vaginal examination, if she had pubic hair. Cameron says that there wasn’t much. House wonders about Alex’s real age and he schedules another MRI. Cameron complains that an earlier MRI showed no tumor but only undersized ovaries. The new screen finally shows what House has been looking for. It looks like a tumor, but it isn’t.
Martin asks House if they found cancer. He says there is a tumor on Alex’s left internal testicle. House explains that Alex has male pseudohermaphroditism. All humans start out as girls but then get differentiated by genes. With men, the ovaries develop into testes and drop. But in about 1 in 150,000 pregnancies, something else happens. Alex is completely immune to testosterone. She is full of pure estrogen, which explains the clear skin and perfect breasts. When they remove her testicles, she will be fine. Alex does not handle this news well.
House approaches Cuddy for another shot of morphine. She thinks it’s curious that the pain returned after House solved Alex’s case. He says he only wants a shot, not a psych session. Cuddy calmly tells him that when she administered the shot, it was only a placebo full of saline. House realizes his pain is indeed in his mind.

House, MD Season 2 Episode 212: Distractions

A sixteen year old named Adam convinces his father Doug to let him drive their ATV. Adam’s eye twitches and he physically cannot control the brakes. Doug is thrown from the bike. He watches in horror as Adam crashes the bike and his body is engulfed in flames.
House reads a friend’s article in an Indian medical journal. Foreman reports that Adam’s heart is suffering from tachycardia and his potassium is low, even though the burn unit is pumping him full of liquids. This could be caused by amphetamines or bacteria or even cardiomyopathy. Yet the skin burned off Adam’s chest means they can’t get an EKG. The team needs to figure out why his heart has shut down so that the burn unit can treat his skin. House thinks they can use a Belgian device from the turn of the century called a Galvanometer. First, they have to find one.
Cuddy is startled to find out that her office scheduled a lecture by a neurologist named Dr. Weber. Unfortunately, Cuddy’s assistant quit because she “couldn’t deal.” Cuddy sees that she didn’t sign the memo, and House admits to forging it. Yet House is more interested in the coma patient who’s showing signs of a migraine headache. House had given the man migraine prevention medicine and then nitroglycerine, which induced the headache. Cuddy is appalled at House’s lack of ethics.
Cameron explains to Doug and his wife Emily that they don’t know if Adam’s heart problems are connected to the burns. They tell her that Adam doesn’t use drugs. Foreman and Chase hook Adam up to the Galvanometer. The boy’s hands and feet are immersed in pots of water. The heart waves at first seem normal, and then suddenly, Adam convulses as if he was being electrocuted. They turn off the machine, but he continues to spasm.
The team runs through why Adam may have suffered a seizure. It could be caused by adrenoleukodystrophy, a virus of the brain, or multiple sclerosis. Yet his burns prevent them from performing an MRI, CT scan or lumbar puncture to find out. There’s no other way to look at a brain. House suggests a sonogram, because he performed one on the coma patient earlier. He didn’t use an MRA because he was doing “something illegal.” They may not get a definitive diagnosis with a sonogram, but M.S. patients’ more reactive neurons may turn up something.
Cuddy awkwardly introduces Dr. Weber to the lecture hall. He is from a center in India and he is there to talk about headaches. House sits in the back, wearing a baseball cap and sunglasses. Wilson notes House’s presence and realizes that House went to medical school with Weber. Weber won an internship that House didn’t get. He also is the one who got House thrown out for cheating. “He’s a bad scientist,” House says. House has been stalking Weber for twenty years and plans to humiliate him.
Chase props Adam’s eyes open and shows him flash cards. Foreman monitors on a sonogram whether Adam has any brain activity. Foreman interrupts House’s lecture to tell him about the bleeding they found in Adam’s brain. Yet House refuses to leave Weber’s lecture. He tells Foreman to fix the bleed.
House challenges Weber’s breakthrough theory on a drug that actually prevents a migraine. He says aloud that Weber published this in an obscure journal in India so that he could get a pharmaceutical company to fund his studies. Weber suddenly recognizes House. He thinks this is just an old school rivalry. House says that he tested Weber’s medicine on a coma patient. It doesn’t work.
Chase inserts a platinum wire coil into Adam’s femoral artery as Foreman follows him with the sonogram. Afterwards, they place Adam in a hyperbaric chamber as they discuss what could be disrupting brain function. They think they can rule out M.S. Suddenly, Adam wakes up in the chamber. His breathing is rapid, but Foreman sees that what Adam is experiencing is an orgasm. They call for an anesthesiologist.
In his darkened office, House shoots himself up with Weber’s migraine medicine. He then injects himself with nitroglycerin, which has a side effect of migraine headaches. Cameron rushes in to tell him about Adam’s orgasm, but House begins to suffer from intense migraine pain.
Foreman treats House for the headache and tells him not to move around. House doesn’t listen and goes into his outer office to hear the team’s theories on Adam. He lies on the floor as they come up with an idea that sensory information is getting misinterpreted by the medial forebrain. Good feels bad and bad feels good. They list a slew of infections that could affect the forebrain, but Cameron wonders if it’s merely a regular infection festering in the burned skin. Unfortunately, they don’t have time to wait for the burns to heal to find out if this is the cause.
Even in his altered state, House comes up with an alternate idea. Several thousand maggots are placed on Adam’s chest to eat the dead flesh and clean the wounds. This will also kill the bacteria that thrive in injured tissue.
House tells Wilson that he must prove that he still has a migraine even after taking Weber’s medicine. Wilson accuses House of using pain as a distraction because he pushed away Stacy, the love of his life.
Later, the team finds House asleep in his office. Foreman is concerned because he should have recovered from his migraine by now. They report that the maggots have treated the burns but that Adam’s brain waves are still all over the map. The infection wasn’t causing the brain dysfunction. House says they should perform a cervical tap lumbar puncture even though it could paralyze the boy.
Foreman gets the parents to sign a consent form to perform the cervical tap. He then inserts a 25 gauge needle between the C2 and C3 areas on Adam’s neck. The needle isn’t penetrating, and Foreman begins to force it. Chase panics when Adam’s blood pressure spikes. He warns Foreman to stop, but Foreman is successful and collects CSF.
Foreman reports to House that Adam doesn’t have M.S. or an infection. House goes to the burn unit and forces the anesthesiologist to wake Adam up. He does, and Adam cries out from the immense amount of pain. House asks him if he experienced any tingling or numbness before the accident. Adam manages to say that he urinated in his pants before he blacked out. House quickly injects Adam’s IV to make him pass out.
House calls for the team to assemble. He takes a shower in the doctor’s lounge. He’s wasted and starts to hallucinate. Cameron finds him and is furious that he took drugs while Adam is fighting for his life.
She tells Foreman and Chase about House. Suddenly, House enters, feeling fine. He has come to the conclusion that Adam is depressed. The urination and blacking out mean that Adam had seized even before they had tested his heart. A tox screen didn’t catch anti-depressants because there are so many drugs in his system from the burn treatment. His brain might be suffering from Serotonin Storm, but if it’s something else, then the treatment might kill him. House wants to wake Adam up again, but the anesthesiologist ratted him out to the parents.
House confronts the parents in the waiting area and asks if their son is depressed. He tells them that Adam suffered a seizure, which caused him to crash the bike. House wants to know if he is taking anti-depressants. The parents say no. Their son tells them everything.
The team has ruled out just about everything that could cause the seizure disorder. House goes back to the burn unit, ready to wake him up. Doug retrieves Foreman, who tries to stop House. House sees a perfect circular burn on Adam’s wrist even though the boy’s forearms are not burned. There is also a nicotine stain on his fingers.
House goes out and asks the parents if their son smokes. Doug quickly says that he would kill Adam if he did. House lets them know that Adam does smoke and was trying to quit. The cheap no-smoke meds are also anti-depressants. Adam can be treated and will recover.
Cuddy accuses House of dropping acid. He informs her that LSD acts on serotonin receptors in the brain to stop a migraine and anti-depressants short-circuit the LSD. Yet House doesn’t cop to doing any of this. Weber storms in and thanks House for ruining his clinical trials by sending the pharmaceutical company an email about his facts. “We’re even,” House says.
Later than night, House is paid an expected visit by a young woman. She introduces herself. “I’m looking for a distraction,” he says, letting her in.