House, M.D. s03e04 Episode Script

HOU-304 - Lines in the Sand

Adam, eyes here.
Follow my finger.
Adam, show me a bicycle.
Eyes here.
Adam, show me a bicycle.
No, buddy, that's a ball.
Adam, look at me.
Are you hungry? Show me what you want for lunch.
He's still drawing those lines instead of looking at the cards.
More juice? If he wants more juice, he has to ask for it.
Adam, buddy, eyes here.
He's tired, Dom.
He wouldn't be if we stuck to the schedule.
Show me the juice, buddy.
I think we've reached the point of diminishing returns.
He has to ask for it.
Adam.
He's choking.
That's impossible.
It's mac and cheese.
Ten-year-old boy who screams for his life for no reason.
He's autistic.
Severely autistic.
Can't talk, can't make eye contact.
Screaming is probably his way of communicating.
And he went to three different doctors who all said just that.
So, clearly that can't be the answer.
His brain can't filter information.
It's a constant assault on his senses.
I'd scream, too.
Or it's something medical-sounding, like dysesthesia.
Parents are convinced that there's something wrong with their son.
Since when did we start believing parents? Or anyone? Where are we going? Elevator.
Dad was on Wall Street, Mom was a partner in an accounting firm.
When their son was diagnosed with autism, they both quit.
So they're over-protective and scared.
That's all the more reason to discount They study this kid.
Heard him scream a million times, but in ten years of caring for him, this is the first time they've brought him to a hospital.
ER checked his throat.
No obstructions, nothing.
Which means the only symptom was a scream, which is diagnostic of nothing.
Kid clutched his chest, BP was elevated, maybe there was chest pain.
ER said the heart was fine.
Don't be so quick to dismiss pain.
Where are we going? Down.
Stool sample to check for parasites, blood culture to rule out infection, and ANA for lupus.
Because he screamed? Could also be an environmental reaction.
An allergy.
Dust, wheat, pollen, a toxin or something he ate.
Check the house.
And run a lung ventilation scan.
Lungs are in the chest, too, right? I had a date last night, she screamed.
Should we spend a hundred thousand dollars testing her? Of course not.
This isn't a veterinary hospital.
Look, if you don't think this kid is worth saving That's not what I'm saying.
That's too bad.
It was a good point.
Kid's just a lump with tonsils.
You know what it's going to be like trying to put an autistic kid into a nuclear scanner? I don't envy you guys.
I want my old carpet back.
We're going to have to do this later.
A kid in the clinic had an accident.
Generally, when people are on the phone I want my old carpet back.
It was stained with blood.
Yeah, my blood, which makes the carpet part of me.
I want it back.
I want to be buried with it.
You think you can get me to do anything you want, regardless of how stupid it is? It's my office.
It's where I work, where I think, where I save lives, allowing you to brag to rich people, so they'll give you more money to spend on MRls and low-cut tops.
I want it back the way it was.
It's identical to the old carpet.
Except without the hazardous biological waste.
I shall not return to my office until every patented, durable micro-fiber has been restored to its rightful place.
Inspiring.
If you don't want to work in your office, work in the clinic.
If you don't want to work in the clinic, go home.
And don't get paid.
Attica! Attica! Attica! Attica! Attica! Attica? He just needs to finish this level.
We only have the scanner for the next half hour.
After that Trust me, you don't want to move him until he's finished.
The sooner we do this test, the sooner we can get you guys home.
Adam, do you think that No.
Ten minutes.
Tops.
If he has a vascular disorder, he might not have He might not have ten minutes? I don't have ten minutes.
No! No! You don't want to do that.
Adam? Adam? I used Metamucil like the doctor told me and finally I was able to use the bathroom.
But I saw something in the toilet I couldn't identify.
I wrapped it in tissue paper, so you could take a look.
Can't you sedate him or something? I could if I didn't want the test results to mean anything.
Painkillers, exercising, we even did that puncture thing, nothing works.
Then this morning, I get up, my back feels great.
I figured I'd better get down here, right away.
Big shocker, Dad's depressed.
Save your time.
SSRls don't cause chest pain.
Wow.
Every minute of every day is booked.
When he eats, sleeps, plays his handheld.
Not much of a life for them.
They chose to have a family.
You don't get to decide what your kid's going to be like.
Nobody chooses this.
It's funny, you get a normal kid, the parent works.
You get a special kid that costs more, you quit and turn the backyard into a therapy circuit.
Yes, if only you were handicapped.
All the good times you could have had with Dad.
Hi, Doctor House.
Hello, girl whose name I don't remember, but whose dad I treated, so I don't really know why she's here.
Ali.
I think I caught what my dad has.
The rhino thing.
Right.
Does that hurt? Little.
It's in my chest, too.
Of course it is.
Kind of had access through the shirt, but this'll work.
That feels good.
Exactly when did New Jersey run out of horny 17-year-old boys? About five weeks ago.
It's been very lonely.
The The ventilation scan was normal.
Time to send him home.
Can't leave right now.
Well, congratulations.
You are the proud owner of your very own "rhino thing.
" A rhinovirus? You can't leave because she has a cold? I can't leave because Cuddy says I can't leave.
All the tests are normal.
Okay, don't start with me.
We're backed up.
I know this is hard for all of us, but thanks to Doctor Cuddy, I don't have an office, so I have to work here.
What did she do to your office? It's unusable.
So whatever's bothering him, it wasn't his lungs.
What about the kid's house? There were some pesticides and some alcohol, but the tox screen was negative.
Which means there's nothing physically wrong with this kid.
We already had that discussion.
We get a fecal smear? Should we do this someplace else? No, Cuddy says I have to work here.
No, I said you can work in your office, or you had to work here.
And since I can't work in my office Is this your master plan? Disrupt hospital business until I replace your carpet? Devious.
Saw it in a James Bond movie.
Fecal smear! Talk to me.
Get out of here.
Put back my carpet? No.
Get out of here.
Fecal matter.
Is there a sample we can look at? The parents have a smear kit.
The kid is constipated.
Do what you want.
Not replacing your carpet.
Go up his rear and get a smear.
Which reminds me, I kind of feel like a bagel.
Carpets.
Need a stool sample.
We should probably wait until he's finished playing that level, huh? I actually think he's a bit better today.
He seems more like his old self.
It's possible that he was never sick.
I guess, we could've overreacted.
Adam? Adam? Adam? Adam? So what makes fluid fill the lining of a kid's lungs? Why are we in here? Is this some sort of power play? Yeah.
So, you stuck your finger in the kid and gave him a pleural effusion? Have you ever considered getting a manicure? I took the stool sample after his lungs failed.
Or do you really have a problem with the carpeting? Change sets you off I said it was a power play.
If someone answers yes to option A, you don't move on to option B.
If there's a pleural effusion, we have to rule out heart failure.
Why now? Why a power play now? I smelled weakness.
Get the kid an echocardiogram.
That's funny.
It says, "James Wilson.
" That's a strange typo.
The fluid comes back and exudates, get him on broad spectrum antibiotics.
Thank you for coming.
No problem.
Thought you wouldn't mind sharing offices for a while.
You share stories, feelings, toys, you don't share offices.
That is so not Zen.
It was a gift.
Some doctors get those.
So, you want mornings or afternoons? You couldn't make Cuddy miserable, so you're going to make me miserable, so I can make Cuddy miserable on your behalf? Yeah.
What makes you think I can make her miserable? 'Cause you're good at that stuff.
I'm nothing compared to you.
Is there anything you'll throw out? That's a gift from an eleven-year-old patient of mine.
She and I both knew it was a piece of junk, and that's what made her laugh.
So you gotta keep it until she She already did.
Adam, I need you to stay still, buddy.
It's okay.
It's okay.
I got him.
There we go.
What? What is it? Is his heart okay? No.
Echo suggested a conduction abnormality, EKG confirmed it.
Still doesn't explain the effusion.
The pleural fluid was an exudate.
We should be looking for something that explains both the heart and lung problems.
An infection, parasite, cancer.
Microbiology showed no organisms in the fluids, so forget infection.
It's not a power play.
Doing a differential in the clinic makes sense, piss Cuddy off.
Same thing with Wilson's office, works indirectly.
But now we're in office space because you don't want to be in your own office.
Which means this has nothing to do with Cuddy.
You really are obsessed with your carpets.
Which means What are you doing here? I have this room booked from two to three.
Two, East Coast Time? I thought you meant Pacific.
Which is stupid of me, I guess.
What about parasites? Stool sample's negative.
It's two o'clock.
Oh, well.
We should go then.
That just leaves cancer.
Get a lung biopsy.
It took a half an hour to get the mask on the kid for the lung scan.
I'm sorry.
Was there somewhere you needed to be? House, can we talk? Carpet? Never.
Nothing to talk about.
Your girlfriend called the clinic Lot to discuss, china patterns House.
She's a stalker.
Right.
Couldn't be that she finds me interesting, attractive, has to be that she's insane.
She's called you 15 times.
Your mother's not that interested in you.
Well maybe I'd be better adjusted if she was.
I'm notifying security.
Is this about the carpet? Do you think I'll back off if you block all my fun? You better not be having fun.
I'm having fun.
I'm not having sex.
She's dangerous.
She's not dangerous.
She's pretty.
She's pretty.
Men are stupid.
I'm with you so far.
I'm notifying security.
Give her a break.
She's not dangerous, she's insightful.
You can't stop our love! Hey, you got a minute? Yeah.
We have a ten-year-old with pleural effusion and conduction abnormality, but no heart failure.
Was there protein in the pleural fluid? Yeah.
That's why we're thinking cancer.
Non-Hodgkin's probably.
So we want to do a lung biopsy.
Lung biopsies usually come back negative, so biopsy a lymph node under the arm.
That's probably something an oncologist should do, right? There's nothing real tricky to it.
It's a biopsy.
Still, just to be safe.
You mind? For the love of God, can't somebody shut that kid up? People are trying to work around here.
Why don't you show him a teddy bear or something? Who are you? Somebody you'll never send a gift to.
This is Doctor House, your son's doctor.
High test, please.
Hey, hey, hey, hey! Out of Vicodin? What are you doing? Eating the red berries.
He trusted you.
No, that wasn't trust.
That was self-preservation.
No.
That was huge.
It was like a conversation.
A monkey's afraid to eat the red berries until he sees another monkey eat 'em.
Monkey see, monkey do.
That's all it was.
Your kid's still just as messed up as when we admitted him.
That was sensitive.
You have pretty hair.
Hope is all those parents have going for them.
No, hope is what's making them miserable.
What they should do is get a cocker spaniel.
A dog would look them in the eye, wag his tail when he's happy, lick their face, show them love.
Is it so wrong for them to want to have a normal child? It's normal to want to be normal.
Spoken like a true Circle Queen.
See, skinny, socially-privileged white people get to draw this neat little circle.
Everyone inside the circle is normal.
Everyone outside the circle should be beaten, broken and reset, so they can be brought into the circle.
Failing that, they should be institutionalized, or worse, pitied.
So, it's wrong to feel sorry for this little boy? Why would you feel sorry for someone who gets to opt out of the inane courteous formalities, which are utterly meaningless, insincere, and therefore, degrading? This kid doesn't have to pretend to be interested in your back pain, or your excretions, or your grandma's itchy place.
Can you imagine how liberating it would be to live a life free of all the mind-numbing social niceties? I don't pity this kid.
I envy him.
No cancer because these aren't lymph cells.
Then what are they? Liver cells.
Wow, liver cells under his arm.
Wonder what he's got where his liver's supposed to be? Anyone got a clue how liver cells got into the kid's armpit? Make yourself at home.
So, you think maybe Gray's Anatomy got it all wrong? Lymph system circulates fluid, not organ cells.
Cancer cells break into the lymphatic system all the time.
But we're not talking about cancer cells.
So what's the difference between cancer cells and liver cells? Why can one pass through walls, but the other can't? Cancer cells are damaged, it lets them grow into blood vessels, go wherever they want.
So if the liver cells are damaged The liver isn't damaged.
The tests were normal.
So if the liver cells are damaged, it's theoretically possible they passed into the lymphatic system.
Liver failure could also explain pleural effusion, even the heart issues.
The liver cells are fine.
He was immunized for Hep A and B, and do you really think this kid is having unprotected sex, or sharing needles? Daddy does seem the type to use a rubber.
So it's not viral.
That just leaves a lot of booze-irrhosis.
Our 10-year-old boy does not have a drinking problem, or cirrhosis.
House, when we echoed his heart, we got a piece of his liver.
There was no scarring.
Cirrhosis explains the symptoms, heart problems, lungs Look up cirrhosis in the dictionary, it means scarring.
Parents aren't doing or dosing this kid.
How would you know that? The kid can't talk.
Why do you think I took this case? He's not going to give away the ending.
They quit their jobs for him.
Yes, they are everything you'd want in a parent.
Unfortunately, their kid is nothing you'd want.
When a baby is born, it's perfect.
Little fingers, little toes, plump, perfect, pink, and brimming with unbridled potential.
Then it's downhill.
Some hills steeper than others.
Parents get off on their kids' accomplishments.
Bend over and relax.
Cute.
They'll annoy you with trophy rooms and report cards.
Hell, they'll even show you a purple cow and tell what a keen eye for color their kid has.
But this kid, he doesn't smile, he doesn't hug them, he doesn't laugh.
His parents get nothing but the right to brag that their kid picked orange juice out of a lineup.
So you figure they slip the kid a mickey so they don't have to deal.
Do a biopsy to confirm cirrhosis.
Don't try to pawn it off on Wilson, he's going to be busy with Cuddy.
My parents love me unconditionally.
Get out of here.
Don't you think the restraining order's a little much? He's not actually going to have sex with a 17-year-old patient.
I didn't think he was going to ask me to dig a bloodstained carpet out of a dumpster, either.
It might be easier in the long run.
Are we stopping here, so House doesn't find us? Unless you want to make out.
You want me to surrender to House's coup? No, no.
You pro-actively give him what he wants.
I defeat him by surrendering to him.
He'll never see it coming.
Look, I'll pay for it myself.
What is it, a thousand bucks to carpet a room? Actually, it's 400.
Not doing it.
Liver biopsy? They're doing it now.
How's it going? Like a biopsy.
Needles, cells, screaming.
What did you find in the stool sample? You were too busy bothering Cuddy.
But as discussed, it was negative for parasites.
Can we get out of here? I didn't ask what you didn't find, I asked what you did find in the stool sample.
Stool and traces of iron, zinc, calcium carbonate.
Can we leave? What's the matter? You afraid of the man? Yeah.
Too late.
Leave my stuff alone.
You have a meeting with a Guggenheim in 15 minutes.
You're wearing that? I'm going to count to three and then I'm going to fire you.
One.
Calcium carbonate? That's an anti-diarrheal, right? Two.
Think that's significant? Think hard poops is significant? Two and a half.
Never threaten unless you're ready to deliver.
Makes you look weak.
Thank God you don't have children.
Doctor Cuddy.
Take a message.
Your patient is being rushed to cardiac ICU.
Wow.
That's like the one thing that would get me out of here.
I'm sorry, you can't come in here.
What's going on? One, two, three.
He's in V fib.
Charged.
Clear.
Charging, clear.
Charging, clear.
Charging, clear.
He's stable for the moment.
First-degree atrial ventricular block.
Okay, what else do we know? His liver's damaged.
Pleural effusion compromised his lung function.
Biopsy was negative for cirrhosis.
Parents didn't poison their son.
It's not his liver, his heart, or his lungs.
It's the calcium carbonate in his stool.
Kid was constipated.
Parents probably just overdid it.
Or they didn't do it at all.
Calcium carbonate is also what's in chalk.
So he ate some chalk.
It isn't toxic, it sure didn't cause the pleural effusion.
Forget the chalk.
You just said it was about the chalk.
Yes, and then I said, "Forget the chalk.
" You must be very confused.
The kid's got pica.
You take him to a buffet, he's going to eat the table.
Or lead paint.
Level of lead in the blood was normal.
His tox screen was clean.
We're not looking for typical poisons.
We're looking for anything that he could put in his mouth.
Matches, spiders, bricks.
Pressure-treated wood used to contain arsenic.
Even better.
Hansel, get samples of the Gingerbread House.
Bag everything.
Hey.
You could get into a lot of trouble being here.
I wanted to see you.
Yeah, I got that.
So did everyone else.
They think you're a stalker.
One could argue those people might be jealous of your attention.
Yes, I actually made that argument.
You going home? That's the plan.
In Iceland, the age of consent is 14.
I'm surprised that tourism isn't a bigger industry up there.
Today I'm jailbait, but in 22 weeks, anybody can do anything to me.
Will I be so different in 22 weeks? Twenty-two weeks is enough for an embryo to grow arms and legs.
It's just a line.
An arbitrary line drawn by a bunch of sad, old men in robes.
Yeah, who cares what judges think? I didn't think of you as a guy who followed rules just because they were rules.
You are over ten years younger than me.
I said, "Over.
" Gotta go! House.
Doctor Cuddy.
Do you happen to know the way to the Icelandic consulate? This young woman, a stranger to me, was just asking directions.
Security was going to call the police.
I don't want to do that to you.
Go home.
She needed a ride.
She got here on her own, she can get home on her own.
Now.
If I see you on hospital grounds again, I will call the police.
After that look, I'm feeling a little frisky.
Looks like you're up.
I'm ovulating.
Let's go.
The frisky, it went away.
House, this isn't a game.
If I leave her alone, can I have my carpet back? No.
If I forget about my carpet can I have her? Jimsonweed.
I found a small patch of it in his backyard.
Jimsonweed contains atropine, poor man's acid.
Our kid's been tripping on "Lucy in the Sky with cubic zirconium.
" Explains the pleural effusion, the heart arrhythmias.
Meeting here will do nothing to upset Cuddy.
I'm not trying to upset Cuddy.
I'm trying to figure out what's wrong with the patient.
Continue.
I'm done.
Jimsonweed doesn't explain the screaming.
You've obviously never had a bad trip.
I would've thought you'd try to accomplish two goals at once.
Why can't you be more like the other age-inappropriate girls who have a thing for me? Just accept me for me.
Continue.
Treatment for jimsonweed OD is physostigmine.
Kid's got heart issues.
The two don't mix.
We'd better make sure that's what he's got.
Serum from the lab in Patterson is three days minimum.
He won't survive three days.
What time does he wake up? Then what? Walk me through it.
the toilet, washes his face.
What does this matter? I'm trying to prove he ate the plant.
His schedule has nothing to do with jimsonweed.
There are two possibilities.
Either the parents saw him eat the plant or the kid has unsupervised time, and eats plants instead of playing with blocks.
Even if you find 15 minutes of free time outside, it doesn't mean he spent it eating a bush.
So, what do we do? Nothing? Wait for the kid to tell us? What? Where are you going? To talk to him.
Ever see your son eat a bush? I haven't.
I've only ever seen him eat Adam, you ate something at your house.
Something that made you sick.
I need you to show me what you ate.
He can't answer you.
Neither can you.
This is your backyard.
You may know it as Mel's Diner.
This is your sandbox.
Your jungle gym.
And under it is this.
I need to know if you ate this, Adam.
He doesn't know what you want.
Adam, you have to tell me because if you don't, game over.
You'll be dead.
What the hell are you doing? Show me what you ate.
Adam, show me what you ate.
Adam? Honey? Adam! Come on in, brothers and sister, welcome to the house of the Lord! House, come on.
The Chapel? We have been blessed with the miracle of a new symptom.
Brother, can you testify as to why this poor child's eyeball rolled back into his head? It's consistent with jimsonweed poisoning, ocular paralysis.
I'm sorry.
The wicked shall deceive ye because they have turned from the Lord and are idiots.
His ocular muscle didn't paralyze, it pirouetted.
MS? It is easier for a wise man to gain access to heaven Will you stop doing that? Just say, "Not MS.
" A stroke, bleed in the brain.
We'd be seeing other symptoms besides a single eye misalignment.
Like a coma.
And you've already testified.
It's a tumor.
And all the imaging just missed it? It's a micro-tumor.
It started in his lung, which caused the pleural effusion.
Then it metastasized to his liver, which made it slough cells.
And then it went to his brain behind the eye, which caused it to roll back into his head.
So, he had three tumors and we missed all of them? What's the opposite of a miracle? I have a better chance of finding it, now that I know exactly where to look.
So, unless you have a better idea, I'm going to go CT his head and then, if I have to, remove his eye.
You remove this kid's eye, he's only going to be half as good at not making eye contact.
Hello? Hello? Hello? I have sad news for you.
She doesn't love you.
You're ugly when you're jealous.
She showed up at my house last night.
Came on to me.
She's even more perfect than I thought.
House, she's sick.
You say, "Sick," I say, "Freestylin'.
" The girl will have sex with an invertebrate.
Come on, you're not that bad.
She has a problem.
You're not doing her any favors by indulging her.
How could you lie like this? Do you not have room in your heart for love? You don't believe me.
I didn't believe the kids when they said that Susie was sleeping with Johnny.
I didn't believe them then.
I don't believe them now.
I don't care that Susie married Johnny.
She's mine.
She has a mole on her right breast, just below the nipple.
No, she doesn't.
You've seen her breasts? It was a medical exam.
I was listening to her heart.
It went, "Greg-House.
Greg-House.
Greg-House.
" Fine.
I'm lying.
But she did come back.
She's locked up in my office.
I was hoping you could talk to her, put an end to this.
Listen to me.
Do you have any idea what you'd have to look forward to if you stayed with me? Nine chances out of ten, we'd both wind up in a jail.
You're only saying that to make me go.
I'm saying it 'cause it's true.
Inside of us, we both know that you belong with Victor.
Is there a Victor in your class? If you're not with someone your age, you'll regret it.
Maybe not today, maybe not tomorrow, but soon, and for the rest of your life.
What about us? We'll always have Fresno.
I'm no good at being noble, but it doesn't take much to see that the problems of two little people don't amount to a hill of beans in this crazy world.
Someday you'll understand that.
Now, now, here's looking at you.
Damn.
Was there an earthquake when you were in Fresno? What? I ask all my girlfriends that.
Yeah, a little one.
Damn.
What? What? What is it? It's not love.
You have spore in your brain.
Coccidioides immitis.
California's full of them.
They get an earthquake, they get released into the air, you breath it in, you get a cold.
Turns into sinus congestion, aches, weakness, milky tears, and sometimes loss of inhibition and judgment.
Damn! So, loving you, wanting to have sex with you was all just the spores talking? You'll probably live.
Damn! Hey! Don't touch his eye! This is an appendectomy.
Like I said, don't touch his eye.
Why isn't he in surgery? Some emergency bumped him.
We've got another room in ten minutes.
You're not taking him in.
Kill the lights.
He was seeing them all the time.
What are you looking for? He was telling us what he was seeing.
Telling us exactly what was wrong with him.
Drawing them for us over and over again.
But nobody knew how to speak autistic.
When I asked him what he ate, he even told me that.
What are you talking about? What was he seeing? Hello, my pretties.
It's not a tumor, Foreman.
It's worms swimming in his eye.
Animal makes potty in the sandbox, boy plays in the sandbox.
Boy eats the sand.
You can probably tell where this is going by now.
Stool samples were negative for parasites.
Raccoon roundworms are not excreted by their human host.
Cameron tested the sand.
All of it? Worms spread from his gut to the rest of his body.
They attacked his lungs, that's what made him scream and caused the effusion.
They invade his liver, sending dead liver cells coursing through his system.
They attacked his eye and the muscles surrounding it, making his eyeball do a back flip.
Laser photocoagulation to fix the eye, and a high dose of benzimidazole to kill the worms.
Wait a minute, that's it? He's going to be okay? Good news.
He's going to be with you for a long, long time.
I'm going to read you something.
"Asperger 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.
" Or broadloom.
It doesn't say that last part, but you get my point.
House doesn't have Asperger's.
The diagnosis is much simpler, he's a jerk.
Why do you think he took this case? Because he believes these parents? Because he wants to help a young boy? He sees himself in this kid, and he's trying to help himself.
He doesn't want this, he needs it.
You're not autistic.
You don't even have Asperger's.
You wish you did.
That would exempt you from the rules, give you freedom, absolve you of responsibility, let you date 17-year-olds.
But most important, it would mean that you're not just a jerk.
At what point does a person endlessly lecturing someone make him a jerk? First tongue kiss is an eight on the happiness scale.
Child being snatched back from the brink of death, that's a ten.
They're clocking in at a very tepid six point five, because they know what they have to go back to.
Listen, thanks.
You saved his life.
Yeah, I know.
See ya.
That was so good.
That was a ten.
All change is bad? It's not true, you know.

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