House, M.D. s02e23 Episode Script

I know that one.
I was at the studio when Grandfather recorded it.
You thinking about your mom? Mama, everything, my whole life.
It was all a lie.
I never knew you.
I never knew you were my dad.
Your life's gonna be okay, Leona.
You're a good kid.
You got it together.
You survived the last eight months on your own.
You're not your grandfather or your mom.
You're not gonna make the same mistakes they did.
I'm proud that I'm your father.
I'm proud that I'm your father.
Glad I'm getting this chance.
I'm glad I'm getting this chance.
This chance Ready for a cookie, darling? We gotta go! Get out of here! Leona! Leona! You've reached a number that has been disconnected and is no longer in service.
If you feel you've reached this recording in error, go with it.
Hang up.
On three.
One, two House, pick up.
I know it's your day off, and no doubt got lots of exciting plans, but I've got a case.
A 16-year-old girl presenting with cardiogenic shock, no heart attack.
Dr.
Willis, 5-2-2-1.
Dr.
Willis, 5-2-2-1.
Her heart looks fine.
ER did a full cardiac workup.
Tox screen's clean, blood shows no infection.
All on the top page.
I'm a real good reader.
Personal chart handoff means there's something else.
I'm hoping it's not personal.
The guy who brought the girl in says he knows you.
I thought I'd met all your friend.
I was also wondering if you could take a look at these.
When you have a chance.
No hurry.
It's just a couple of medical histories.
One with a minor cancer concern.
No problem.
G- man! You thought I was gonna do it, didn't you? Do I know you? Come on it's me.
Crandall.
Doesn't ring a bell.
Man, I can't believe Unless you mean Dylan Crandall, a man who will believe anything.
See, I just made you believe that I You haven't changed.
Heard about your leg.
Yeah.
Pulled a hamstring playing Twister.
Just gonna walk it off.
So who's the girl? Jesse Baker's granddaughter.
You always said you'd give your right hand to play like him.
No.
I said I'd give my right hand to have his left.
Why is she with you? She lost her mom in Katrina, her home, everything.
Wow.
And I'm her father.
Hmm.
Yeah, she looks just like you, got the same 'fro.
I wrote a book about Baker.
Hung out with him, his daughter.
Yeah, that is how babies are made.
I never knew.
She never knew.
Her mom lied for 16 years.
That's unbelievable.
Yeah.
No, seriously, I don't believe it.
Her mom was pissed at me about my book.
I trashed her and her dad.
She wouldn't talk to me, obviously she's not gonna tell Leona that You're a sucker.
You always were.
Does that mean you're not gonna help her? Why wouldn't I? She's not scamming me.
Acute myocardial infarction? ER said no.
Retest.
Wolff-Parkinson-White Syndrome? ER said no.
Retest.
And read the damn file.
You just gave them to us.
Delta wave on the EKG It's all a no.
Everything about her heart is healthy.
She's a Katrina victim.
It's better than Crandall.
He's a Katrina-victim victim.
I don't think she was expecting your sympathy.
I think her point was New Orleans was a Third World country: toxins, mold, sewage in the streets What if her heart is like my bike? Runs like crap when I'm by myself, but I take it to the mechanic, it runs great.
An arrhythmia.
A one-time event.
What are we gonna do? Keep her in her room on a cardiac monitor till she has another arrhythmia? That could be weeks.
Months.
Relax.
I happen to know she's going to have one right after lunch.
We are golden.
You can't induce an arrhythmia in someone whose heart nearly gave out 48 hours ago.
Sure you can.
It's kind of technical, but you stick all these cool little wires inside her somehow I mean you shouldn't.
Oh, right.
'Cause it'd be much more ethical to let it happen in an uncontrolled setting, 'cause there's always a team of cardiologists having lunch at the next table.
This is Jersey.
She's a minor, she's gonna need consent.
I'll go talk to him.
Oh, that's an excellent plan.
We'll give him the form, and tell him it's wrong and dangerous.
I can handle a simple consent form.
Okay, I'll be Crandall.
Dr.
Cameron.
House, from what you say, this guy will Are you in this scene? Go.
I need to talk to you about a procedure we'd like to do on Leona.
"Like to do?" Is this fun for you? He's not you, he's not gonna mock me.
Stay in character.
I'm so scared, hold me.
In order to figure out which circuit is misfiring, we need to map all the electrical activity in her heart.
Swear to me on the Bible you'd do this if it was your kid.
Goodbye.
To map the electrical pathways in a heart, we send electricity through each, one at a time, till one fails.
That sounds dangerous.
It's a risk I'm prepared to take.
If she's got an electrical problem, couldn't more electricity blow her whole system? Well, look who's been watching Bill Nye, the Science Guy.
The test is perfectly safe.
We do it every day.
All right.
And you believe me? I shouldn't do the test? It's crazy dangerous.
Just sign the damn form.
I'm not crying.
I can handle this.
Then blow your nose, I need DNA from somewhere.
You're not running a paternity test.
She's gonna stay around just long enough to get your bank account, your credit card numbers, then she's gonna be off with her next daddy.
With what she's been through, why would you assume Because of what she's been through.
Because that's your default position, always has been.
Because she's still alive.
Raised by a junkie, living on the streets, that tends to kick the sweetness out of you.
I figured you'd have mellowed.
Because you're an idiot.
If I let you do the test, it means I don't trust her.
No.
It means I don't trust her.
She's out.
Heart rhythm's normal.
Insert the first catheter.
I'm in.
All heart rhythms still normal.
Haven't zapped her yet.
Send the first electrical pulse.
Sinoatrial node is normal.
Next.
Got supraventricular tachycardia.
Stop the current.
Is she hallucinating? IV push stat, 12.
5 adenosine.
She's crashing.
BP's plummeting.
Foreman, is she hallucinating? No, normal waves.
Then the AV node is not the bad pathway.
All that was, was a heart attack.
Reset her, so we can find the real problem.
Charging.
Clear.
Normal rhythm.
Chase, high right atrium, please.
Her heart's fragile after that last attack.
Chances of tachycardia.
You have my permission to blame Foreman at any negligence trial.
Send the electrical pulse.
That's the one.
She's hallucinating.
It's near the coronary sinus.
Freeze it.
Damaged heart muscle gone.
Cryoablation complete.
EEG's back to normal.
No hallucinations.
She'll be fine by breakfast.
Interesting reading.
Those are my top two choices for sperm donors.
I wanted your medical opinion on genetics.
They're losers.
Medically? Or Donor 1284 likes square dancing.
No one likes square dancing.
medicine for five minutes, calls himself a healer, loves Mozart.
I'm not going dancing with them, I'm looking for healthy sperm.
He's got four living grandparents.
Who they are, what they do, that doesn't matter? I'm leaning toward 613.
Oh, sure, go with the Jewish number.
positive for the BRCA gene.
But his mother was negative, which means so is your baby.
What about the Mediterranean/Dutch factor on the dad's side? It's not a problem, because his dad's mom didn't carry the thalassemia gene.
Bigger issue is the jerk and poser genes.
This Mozart lie.
People can't like classical music? You're designing a kid, a loser kid.
He's already getting pummeled at recess.
Here, knock yourself out.
Go find sperm that can beat up 613's kids.
And thanks for your help.
Pretentiousness is hereditary.
Just 'cause they haven't found the gene yet Could I have some water, please? Hello? I just need some water.
Is anyone there? Mama? The second hallucination means we didn't fix her heart.
Maybe we missed something.
Her heart's fine.
If she hallucinated, it wasn't caused by her heart.
If? The screaming, the floundering, it was an hallucination.
What if it wasn't a hallucination? We covered Not finished.
What if it was an atypical seizure? Seizure? She saw her mother.
Mother's dead.
Ergo, hallucination.
Anyone wanna explain that? His leg hurts.
Walking takes his mind off of it.
Flashback! All that wind and rain from the hurricane, post-traumatic stress syndrome.
Why are you so bent on her not having a hallucination? If she did have a hallucination, then the heart problem that we predicted, found, and fixed was just a gigantic coincidence.
His leg always hurts.
It's getting worse.
What if the heart isn't a coincidence, and isn't what caused the hallucination? An arrhythmia hurts.
What if her hallucination was caused by pain? What if she has a disease that translates pain into a bizarre physiological response like a hallucination? She has an autoimmune disease.
She needs a CRP, a rheumatoid factor I can prove an autoimmune disease in five minutes.
She needs a PET scan.
You can't test for autoimmune in a PET I'm proving that her hallucinations are a consistent response to pain, which proves that she has an autoimmune disease.
How do you test someone's response to pain? Easy.
Hurt them.
It's not gonna hurt at all.
We just need to make sure you don't move.
I won't.
Okay, give me your arm.
I need to check your muscle responses.
Okay, turn it over.
Palm upward.
Everything okay? Yeah.
What the hell was that? Diagnostic test.
Cerebral cortex responded normally.
She's not hallucinating.
You know he's not your father, don't you? He's my dad, Mama told me.
I'm sorry, I didn't mean to hurt you.
House, leave her alone.
Come on.
We both know it's a hustle.
Are the walls closing in? No.
Why are you doing this? Spiders coming out of my nose? Let me out.
House, the test is over.
Dorsolateral prefrontal cortex Give me your hand.
No! Give me your hand.
Forget him.
He's not the perfect mark, because he was the perfect mark.
Plenty of people got there before you.
He's used up, tainted, pumped dry.
She's hallucinating.
She's lost everything, and you're breaking fingers.
A new low.
Diagnostically, she needed to be hurt.
I wanted to hurt her.
Win-win.
What I didn't consider was a threshold to trigger the hallucinations.
Otherwise, I'd have done the finger-bending first, instead of stabbing her twice.
That was cruel.
If her autoimmune disease is this advanced, usual treatment is not gonna help.
We don't even know which autoimmune disease she has.
This could be Lambert-Eaton, could be Graves' Good point.
Let's kill them all at once.
The only way to do that, is to replace her entire immune system.
Good point.
Let's do that.
Bone marrow transplant requires an exact match.
Leona has no siblings.
Good point.
She's all alone, poor thing.
No one in the whole wide world.
I asked for this tuned.
Did you get this instrument tuned? If my daughter needs bone marrow, why are you looking in a bone marrow registry? Because that's where they keep the bone marrow.
I'm her father.
How does somebody who believes absolutely anything become a non-fiction writer? Test my bone marrow.
Here's how this is gonna end: One day, you'll be sitting at your computer, writing one of your little music books, and your daughter will come home with a big, angry policeman, who'll throw you in jail because, "Daddy touched my poozle.
" Test me.
Happy to.
Just my marrow.
I'm not authorizing a paternity test.
You're that afraid of the truth? I know the truth.
Easy-Lay Fay's truth was that she needed a bus ticket home to see her sick grandma.
You gave her 100 bucks.
She bought weed.
I know, because I told her you'd go for the sick-grandma story.
If our friendship means anything to you Come on.
Do you know me at all? If you do the test, one of two things happens.
Either you're right or I'm right.
If you're right, I'll be miserable.
And if I'm right, I'll hate myself 'cause I didn't trust her.
Either way I lose.
They don't itch, not raised.
He's had his MMR, no one's sick at school.
His father took him camping.
We caught two spiders.
You didn't tell me about the spider.
Did you get a new couch? Do you think there might be some sort of toxin What color is it? Red.
Is that where you watch your cartoons after you take your bath? Mmm-hmm.
Fall asleep sometimes? Yes.
Bless you.
Need you.
Now.
Yes, mistress.
I'll write you a prescription for one of these.
Just wet and apply.
You didn't tell anyone else what I'm doing? Not a soul.
Wilson? Cameron, maybe you mentioned it to her? No.
I'm a really good secret-keeper.
I've never told anybody that Wilson wets his bed.
Oh, you tricked me.
Part of the protocol for in vitro fertilization is twice-daily injections of menotropins.
I can't do it myself.
Turn around.
No clever comments about bending over? Not unless you want me to.
I'm just not used to House the professional.
I was just thinking about what your mother looked like.
'Cause your father obviously chose her for breeding purposes Shut up.
Natural selection sucks.
We pick our mates based on breast size, cars they drive.
They did autopsies on married couples, found a correlation in pancreas size.
We're hardwired to pick for stupid reasons.
You have the chance to pick for smart reasons.
I think the Germans had a similar theory about 60 years ago.
I'm not advocating wiping out entire races, I'm just saying you don't wanna mate with the first plastic cup that buys you a drink.
I'm pretty sure you got that.
Microbes can be sneaky.
Thanks.
Twice a day.
This is gonna be fun.
I got it.
So why were you friends with this guy? We were 20 years old.
He had a car.
If he'd been a woman, I would have married him.
Is he a match? No.
Lying girl lucked out, we found one in the registry.
Is he the dad? I don't think so.
You didn't run the test? Said I wouldn't.
Okay, so either you lied, or he has pictures of you being nice.
Stop the radiation.
What the hell is that? I have no idea.
Lab results on the black ooze.
You're not gonna believe it.
She pooped out of her mouth.
The sample contained stool and digested blood.
How did you guess? 'Cause it oozed.
If it was in her stomach, it would've sprayed.
If it was in her lungs, she would have coughed.
This oozed, as in squeezed, as in reverse peristalsis.
Who's hungry? Mexican takeout? In order for digested blood to be in her intestines, she had to have internal bleeding.
Yeah, but for whatever was in her intestines to come back up, there had to be a blockage.
Liver failure.
There'd be no proteins to clot the blood, so it would leak into her stomach, mess up her intestines.
Means, oops, we were wrong, because no autoimmune disease shuts down an organ in two hours.
We need to do a liver biopsy, find out what the real problem is.
Hey.
Need to talk to you.
The good news is, she doesn't have an autoimmune condition, so she doesn't need a bone marrow transplant, and we were able to stop the irradiation in time.
The bad news, she has potty mouth.
Her liver is failing which has made her digestive system go in reverse.
It's actually much worse than it sounds.
We need to do a liver biopsy.
I don't know what's gonna happen when we stick a needle into her liver.
She could die right then and there.
Ease it.
Tell me what to do.
No inside information on this one.
Look, Crandall, three days ago, you didn't even know this girl.
If she'd been hit by a bus, you wouldn't lose a moment's sleep.
There are people all over this hospital in just as much trouble, just as not related to you.
You telling me I shouldn't care? Prepping me to handle it for when she dies? It's brown, it's lumpy, I'm going to heave all over my desk.
Chicken mole.
Twenty-one herbs and spices.
I find it very comforting, you defending a man you haven't seen in years.
To know my friend, no matter what, will always be my champion, my protector.
I'm not protecting him, I'm smacking her.
The modesty of the true hero.
Push me and I'll let her die, just so you'll stop annoying me.
Here's my theory.
You're jealous.
He's maturing, he's accepting responsibility, you're emotionally stuck at 17.
He's manufacturing responsibility, he's not maturing.
He hasn't changed at all.
So, then why do you care? That black ooze we saw? That was a bowel movement out of her mouth.
You're trying to end this conversation by grossing me out? I'm an oncologist.
Half my patients have their skin sloughing off.
Why are you so worried about this guy? He was having a rough time with his girlfriend.
He was in love, he's always in love, he wanted to marry her.
And I thought she was flaky, was sending mixed signals.
So you gave him advice, and she dumped him.
No.
I told him that I would talk to her.
And you blew it? Technically I was doing him a favor.
She was nuts.
Stop the biopsy.
I'm right at her liver.
It's House.
He says stop.
Check it out.
Look, please tell me you didn't stop the biopsy to play us some tunes.
The left hand is very subtle, very delicate.
This girl is dying.
Be dying a lot faster if I let you do that obviously unnecessary biopsy.
Now, listen.
I asked for this tuned.
Did you get this instrument tuned? My God.
Grandpa was an angry drunk.
If only we'd known! Here's how to become a great artist.
First, get miserable.
Misery drives you to become a great artist, but the art does nothing for your misery, which drives you to drugs, which makes you a lousy artist.
And this is not lousy.
You saying he didn't do drugs? Not when he played this.
Something was screwing with his personality.
Yeah.
Drugs and alcohol don't do that.
And that note that he says is out of tune, it's not.
Which means that something is screwing with his aural perception, too.
Now, what happens when you add all of that to the liver disease, which he supposedly died of? Too much iron.
He could have had hemochromatosis.
That's genetic.
Unless you can tell me Miles Davis couldn't play stoned Played better when he wasn't.
I think.
I mean, no one knows for sure.
I'll get Leona a TIBC and serum ferritin.
We can test this in three minutes.
So, what is she, Foreman, a light-skinned black chick or a dark-skinned white chick? I'm not sure.
Can we hear the music again? It's too early to see jaundice from her liver.
True.
But this is a photograph of Leona when she was 13 years old.
She's darker now.
She's been living on the streets for eight months.
No tan line.
So, unless those streets she's been living on are indoor streets, I'm thinking she's got iron deposits in melanin.
Both byproducts of hemochromatosis, just like Granddad used to make.
SQUID exam to calculate the amount of iron in her blood, and treat her with deferoxamine.
She'll be fine by lunch.
'Cause, you see, I was wrong before about the breakfast.
There's the iron.
Lots of it.
I'm not gonna get this job, am I? It's a done deal.
I knew it the moment I saw you.
Interview's just a formality.
House, what are you Lisa Cuddy, this is Patrick Linehan.
Patrick's gonna be the new intern rotating in my department.
I didn't even know you were looking for one.
Nice to meet you.
Sorry.
I laugh when I'm nervous.
Bet you've been doing that your whole life, huh? What kind of medicine are you interested in, Patrick? Cancer, infectious disease.
The big devils.
I think that medicine has become too institutionalized.
We need to send a message to our patients that we're just like them.
I mean, we're all people.
"We're all people.
" I like that.
See, she's all hard science, facts.
I like to know a person's hopes and dreams.
What kind of music do you like, Patrick? Actually, I don't I'm a Mozart man.
He says what I feel but can't express.
I'm late for a meeting.
You see, this is why the face-to-face interview is so important.
You gotta know who you're getting in bed with.
Get him out of here.
Deferoxamine is a chelating agent.
It binds to the iron, so that her liver can get rid of it.
Once the iron's out of the liver, it's finally evacuated by the body in the form of urine.
Should be quick and painless.
Leona? What's happening? Crash cart.
She's not getting any air.
CT showed her lungs are Swiss cheese.
Ventilator's helping, but at this rate, her time's basically up.
We developed a theory, hemochromatosis.
Like good scientists, we tested that theory.
We proved that theory.
We acted based on that proof and we treated her.
As a result of which, she is on the verge of death.
Is it just me, or have we discovered a flaw in the scientific method? Walk me through it step by step.
What is supposed to happen when you give someone deferoxamine? It's a chelating agent.
And what does the chelating do? It removes excess iron from the liver.
How? The iron is heavy, it gets stuck.
Deferoxamine is like a lubricant.
It makes the iron slick, so it can move around again.
Moves around where? It's supposed to be discharged through waste.
Her waste system is a little screwy right now.
Means the iron can't go where it wants to go.
What if it moved to her lungs? Then whatever's in her lungs likes iron, bound with it, started poking holes.
What likes iron? Oxygen attaches itself to iron, which increases her chance of infection.
No, we started massive antibiotics prior to the radiation.
Some neurodegenerative diseases like iron.
MRl was clean.
No iron deposits on the brain.
Fungus likes iron.
No objections to that one? If a fungus is doing all this, she's dead.
There are 25 antifungals, if we don't know which fungus When in doubt, go broad.
Most common is aspergillus.
Continue to ventilate her lungs.
Get her on a voriconazole drip and hope she has aspergillus.
The process is confidential.
You violated his privacy.
But how did you even I looked up "loser" in the cryobank.
You wouldn't go within Yet you're willing to have his baby.
I'm not looking for a date, I'm tired of looking.
Cotton ball? I don't care if you marry this guy, date this guy, go through his garbage, but you should know.
Genes matter.
Who you are matters.
Find someone you trust.
Someone like you? Someone you like.
Listen Oh, sorry.
Okay.
It's not what you think.
I rub his leg.
Oh, Ingrid.
Hi.
Okay, you feel guilty about stealing the guy's girl, I get that.
And I'm glad, it's a good thing.
But you did the paternity test.
And either the paternity test comes back negative and you shove it in the guy's face, or it comes back positive, and you shut up, and your leg starts hurting.
Or I never ran the test.
Not what you think.
Leona's lungs collapsed.
The treatment's not working.
We've got the wrong fungus.
You can stop.
She ruined it.
Three rules for hunting fungus: location, location, location.
Crandall says she was living at the children's shelter in Ridgeland.
Okay.
The one thing we know for sure is she was not living in the children's shelter in Ridgeland.
Why would he lie about that? He wouldn't.
But he'd believe her story about the sweet little girl trying to do the right thing.
We can't ask Leona where she was.
She's intubated.
Don't try to talk.
You got a big medical thing in your mouth.
Just blink if you understand me.
Fantastic.
Blink if you lied to Crandall about everything.
You picked up a fungus somewhere.
If you were living at this shelter, like you told your new daddy, then I got nothing to go on and you will die.
So, did you lie to Crandall? You're a lousy con artist.
First rule of the game is know your mark.
Once you got Crandall to bite on the papa thing, you had him.
You could have told him that you were servicing Al-Qaeda suicide bombers for crack, and this guy would still have let you pick out the colors in your new room.
Did you lie to Crandall? Where were you? And the winner is Oh, you read it, I just get so nervous at these things.
Recording studio? She read the book.
She knew how much Crandall hated that place, what went on there.
She overplayed her hand.
She was desperate.
If she didn't sell this, she was stuck in hell.
Recording studio doesn't help us medically.
Recording studios.
Why are these buildings different from all other buildings? Sound-proofing.
Absorbs sound, also absorbs moisture.
Where there's moisture, a lot of it, say Katrina-moist Zygomycosis.
Only occurs at the highest levels of mold.
Start her on an IV drip of amphotericin B with colony stimulating factors.
She'll be fine by dinner.
She's gonna be fine.
She said she'd never go back there.
She lied to you.
She's your kid.
Get used to it.
Thank you for the injections.
You're welcome.
You came all the way up here just to tell me that? No.
Pretty much normal.
Liver function tests are good.
Thanks, G-man.
What makes you think you'd be a good father? I don't know.
It feels right.
It feels good.
Well, at least you got a good reason.
Feels good is a good enough reason.
What's happening? She's choking.
She can't breathe.
Get him out of here, will you? Come on Out! Quick, the curtain! You're breathing on your own.
The choking's normal.
I lied to him.
I ran a paternity test.
Your lie was a bad one.
He is your dad.
We're even.
Your machine's broken, there's not even a message.
House? Are you there? Okay.
See you Monday, I guess.