House, M.D. s05e20 Episode Script

HOU-520 - Simple Explanation

Bye.
I want to be alone with my wife.
I'm a selfish SOB.
I never got you to Rio.
There was always one more problem at the stores.
You deserved better than that.
I love you.
I always have.
I'm ready.
It's okay.
I know Somebody help her.
Help her! Fifty-four-year-old woman with acute respiratory failure.
No anaphylaxis, lung issues or tracheal lesions.
Tox screen was clean for coke and amphetamines.
I will give you 30 reasons, one for each pound that caused the apnea which inflamed the epiglottis.
Why's our rainbow coalition missing Brown and Bi? Thirteen's with the patient, and Kutner's dog's sick.
He should be in by lunch.
No apnea because no sleeping problems when she's sleeping.
She's spent the last six months caring for her husband who's dying of heart failure.
Reason 31, whatever whacked the husband's heart is also whacking her airway.
And, oh, good, I thought maybe Kutner was home nursing the rib you broke when you elbowed your way in for credit on the last patient.
I contributed.
And the patient's illness wasn't caused by her husband unless lung cancer is contagious.
Interesting.
Not about the patient, that was kind of dull.
I thought maybe you were lying to cover for Kutner, which sounds noble except you're doing it out of guilt, instead of love.
She visited her sister in Hawaii about six months ago just before her husband got sick.
Could've picked up melioidosis from one of the islands.
Would have jumped to the husband finished off him and his lame immune system.
No tumors, no drugs, no bacteria Leaves viral.
Varicella zoster.
Start her on IV fluids and acyclovir.
Can't.
She's demanding to be released so she can get home to her husband.
How sweet.
They can die together instead of separately, She claims he got stronger as soon as she stopped breathing.
The mind can heal the body.
Seeing his wife in distress might have actually slowed down his death.
Or he just had an adrenaline surge when he saw his chance to hit the singles market.
Send her home.
We don't need to.
I had an idea, all by myself.
Eddie? Found him loitering in the lobby.
You're still with me.
Where the hell else am I gonna go? And now, with your permission we'd like to try to make you better.
The pageant starts in an hour.
You have to do something.
There's something wrong inside her head.
It's like she has no idea what's going on around her.
I thought she was just flirting with me.
I could fix it, but it's gonna cost you $3.
75.
Well, I'm not just gonna give you my coffee.
Think of it as Costa Rican sober juice.
She's drunk? That little minty scent hiding beneath the rose petal perfume and the cherry blossom moisturizer and the morning dew hairspray You sneak into Mommy's bathroom and gulp some of her mouthwash? Gotta be perfect.
You spit it out? Mommy doesn't.
Treatment worked.
Charlotte's breathing's back to normal.
She's being discharged.
She can resume her vigil over her husband.
He's started fading again.
Win some, lose some.
And, strictly speaking, since he's not my patient, win some.
Oh, look at the time.
It's half past Taub was lying about Kutner.
He probably went to a comic book fest spent the night at some Wonder Woman's lair.
I'm sure he'll Find out what, or who, he's doing.
Either way, Cuddy's gonna want me to write it under "Reason for Termination.
" Is that Kutner? Charlotte.
O2 sat and S-T are normal.
It's not her airway.
You're okay.
Yeah, don't worry about me, she's in pain.
Pulse is rapid and regular, no fluid in her lungs.
What's happening? I don't know.
Kutner.
It's Foreman and 13.
Where are you going? House didn't ask us to find out where he wasn't.
If you wanna climb a fifth-floor fire escape This might be faster.
Kutner! Man-boy heaven.
Surprised he ever leaves.
There's nothing on his calendar.
His pager's still here.
Oh, God.
Need an ambulance at Twenty-eight-year-old male, single gunshot wound to the right temple.
No pulse.
Alert Princeton-Plainsboro, have a trauma unit ready.
His pupils are dilated, his head's swollen.
Still no pulse.
Come on, Kutner! Let me try.
He's cold.
Eric.
He didn't say anything to any of you? Family problems? Bad relationship? Financial pressures? His parents were shot right in front of him.
Parents are ancient history.
Not to someone who actually cares.
He didn't slit his wrists and peacefully drift away, he shot himself.
He didn't leave a note, that means panic.
Which could've been pre-empted if the idiots who worked alongside him for 80 hours a week had seen this coming.
You're blaming us? I'm just trying to figure it out.
We would've helped him if he'd reached out to us.
He didn't.
We should've picked up on something.
This isn't our fault.
Something like 25% of suicidal people show no outward signs of depression.
No, 25% of suicidal people have friends who didn't notice anything and don't want to feel guilty.
Killing yourself also kills all other options.
Makes Kutner an idiot.
So pity, yes, but guilt, no.
If that's what you want to tell yourself.
We still have a patient.
Actually, two.
One worsening, one who should be worsening.
You can't be in denial about Kutner and the husband.
It is possible Eddie's body is willing itself to live.
Well, call the tabloids.
Tell them you just witnessed the miracle of slightly increased kidney function.
Maybe we should pass this file off to another doctor.
And the next one, too? And the one after that? How many files till it's okay that Kutner's dead? Cardiac enzymes means she didn't have a heart attack.
No vision problems means no mitochondrial disease.
Could be a metabolic disorder.
Acidosis.
Blood pH was normal.
Polyserositis would inflame the membranes near her epiglottis and the heart's pericardium, causing the chest pain.
I'm sorry.
I've hired a grief counselor, who I'm sure none of you will see.
And I'm offering time off, which I'm sure none of you will take.
But just know it's available.
Polyserositis fits.
Start her on indomethacin.
If you'd rather not deal with this case I'm fine, despite what Wilson will say.
He hasn't come to you? Pretty sure he has Mah-jong Tuesday mornings.
I assume he thinks that I will work through this better if I don't have to keep flicking his wings off my shoulder.
You didn't even have an inkling? I know his fantasy football team cratered, figured he'd gotten over it.
Well Sorry for your loss.
Thanks.
It's not my loss.
Then I'm sorry you don't think it is.
Patient's membranes aren't going to heal themselves.
Taub went to run the treatment.
We'd like to go see Kutner's parents.
I'll join you.
Polyserositis damages the protective covering around tissue and organs.
The indomethacin is simply an anti-inflammatory, but it should fix it.
Just make the pain stop.
Charlotte.
Close your eyes.
Now.
Pretend you finally made it down to Rio.
You're on the balcony of Some fancy hotel.
You never talk like this.
Yeah, just shut up and let me do this.
And you're on that balcony, and you are watching the Mardi Gras.
It's called Carnival.
And I don't want to go without you.
I want you to.
And I want it to be everything you've ever dreamed of.
Sorry to interrupt, but I'd like to run one more test.
On you.
This is the first day we got him.
He was six.
Sweetest little boy you ever met.
Must have been scary going through a trauma, and then being handed off to a new family.
We kept telling him to call us Richard and Julia but it was always Mr.
And Mrs.
Kutner.
Then, on his ninth birthday, we gave him a chemistry set.
Lawrence always loved blowing things up.
And he said, "Thanks, Mom.
Thanks, Dad.
" That's who we were from then on.
He was pretty special.
We were lucky to have him.
You spent the most time with him.
He spoke so highly of all of you.
Do you have any idea I wish we did.
We all - It was his name.
He was conflicted.
Didn't know where he fit in.
Being ripped out of his world and stuck into yours.
We encouraged him to hold on to his heritage.
It's hard to still be Lawrence Choudhary when everyone sees you as Lawrence Kutner.
It was his idea to take our name.
You should have said no.
House.
All his Anglo name gave him was the illusion that he was someone he wasn't.
You were being emotional, not rational.
You didn't understand him.
We loved that boy, you son of a bitch.
You wanted to make him happy by shutting out his pain.
When he looked happy, you assumed the pain had gone but it just got buried deeper leaving him tormented about who he was, until finally he put a bullet House.
Go back to the hospital.
I'm sorry about your son.
Indomethacin had no effect, she's still in pain.
Rules out polyserositis.
I ran a hormone panel on Eddie.
His prolactin's above normal.
Means he's actually improving.
Body chemistry changes for all sorts of reasons.
Stress, fear, why not love? Maybe he's going into some sort of remission.
You haven't asked if I learned anything relevant from the Kutners.
If you had, I'm sure you'd have mentioned it.
Or you're just afraid there is something relevant which would mean you could have saved him.
I don't buy that suicide is always a cry for help.
Sometimes you just don't want help.
Good thing you got some or you'd have tried again and gotten it right.
She doesn't have Wegener's.
Kidney function's normal.
It's not byssinosis, it's not mitral valve stenosis.
Nothing fits.
If it doesn't fit any diagnosis that just leaves one diagnosis.
I'm Dr.
House.
You have hypertrophic cardiomyopathy.
His heart is too weak, yours is too strong.
Good news is it's fixable.
We induce a massive heart attack and kill off the extra muscle.
You want to give me a heart attack? It's only dangerous if your heart is normal-sized.
But since all the Are you serious? No.
This is actually very annoying, and I'm getting really bored of lying to patients to scare them into telling me the truth.
She's faking.
And, yes, if she keeps faking I'm going to eventually do something that will kill her.
How could she be The windpipe thing? That was real.
The treatment made her better.
But good for her was bad for you, which was bad for her so she made herself bad.
It's all so simple.
She figured that the sicker she was, the longer you'd hang on.
Charlotte? We haven't been this close for years.
I wanted to hang on to that.
Oh, please.
People hate reruns.
It's my leg.
I swear, this is real.
Do you pinky swear or you just plain swear, because How can she fake that? She can't.
So, what can shred an epiglottis and make muscle disappear? Mr.
And Mrs.
Kutner.
They caused Kutner's death, why not Charlotte's? Mourning period's over.
Foreman's sense of irony is back.
I was wrong about the ethnic reason.
Step one, change your name back.
Step two, if step one fails, move to Bangalore.
Step 14, if step 13 doesn't work, kill yourself.
So, what now? You gonna insult your way through his rolodex till you find someone with an answer? I've been polite to the friends I've called, all of whom were useless.
They weren't useless, they just didn't know anything more than we did.
Tomato, tomato.
MS.
Weakens myelin sheath, compromises nerve conduction.
I'm talking about Charlotte, the one who's still alive.
You two, stick her in an MRI, confirm MS and you, run the echo on Eddie that you're planning to do behind my back to see if his heart's improving.
Did you let me hire a pervert? Well, it'd be hypocritical of me not to.
Kutner's police background check from when he started.
He was charged with indecent exposure.
Kutner streaked at the Penn-Dartmouth football game.
Precisely the kind of thing you'd expect him to do.
It's okay.
You should be upset.
He thought like you, pushed boundaries like you.
If he thought like me he'd have known that living in misery sucks marginally less than dying in it.
Just a few more minutes, then we'll get you back to Eddie.
What's it like, 30 years with the same man? Great for me, good for him, I hope.
What, you don't think he loves you? I think he always loved me, in his way.
Just not in a "spend time with me" or "show emotion" or "any affection for me" sort of way.
Why did you stay? I didn't need him to feel about me the way I did about him.
Love doesn't Charlotte? I've heard stories of cancer patients going into spontaneous remission.
You think this might be that sort of thing? It's unlikely, but you never know.
If I just had a little more time to be with Charlotte.
Try and do better by her.
Yeah, maybe.
You don't think I mean it.
I think you mean it now.
I think it's much easier to mean it than to do anything about it.
Chamber walls are barely moving.
I'm sorry.
He needs a friend.
I can't deal with this and House.
You need a friend, too.
You couldn't give a crap what I need you just want someone to take care of him.
He told Kutner's parents it was their fault.
Ruptured spleen.
Means it's not MS.
What are you doing here? Waiting for you to fix her spleen, so we can biopsy it for rheumatoid arthritis.
I'll do it.
Go home.
She's not your patient.
And Kutner wasn't my friend.
Kutner wanted to die, Charlotte doesn't so in a contest for my concern and interests, she wins.
Okay, either you're a cold-hearted bastard or you're too miserable to face it.
Go home and cry.
It's not rheumatoid arthritis, her liver's scarred.
Whatever she's got, it's spreading.
For the record I'm uncomfortable violating a dead colleague's dignity.
It's only violating if we find something.
Good to see you.
What are we looking for? He was hiding.
Why? Shame? Fear? Are you okay? It's okay not to be okay.
"Colonial Warrior Blaster.
Number 101.
" He spent months tracking this down.
He had passions.
He was obviously in pain.
Does it really matter why? He hung the bad with the good.
His loss beside a reminder of what he'd gained.
Means he was open about the pain.
Should mean that if it got worse, he had no reason to hide it.
Here's how we're gonna handle this, House.
We're going to leave here and go to the closest bar and drink tell stories about the time Kutner almost blew up an OR and pass out in our own sick.
Sound like a plan? What am I missing? You've got that look.
You figured this out.
You're not here because you care about Kutner.
You're here because it's a mystery.
You're here for the puzzle.
What if I didn't miss anything because there's nothing to miss? He didn't kill himself.
He was murdered.
Epiglottis, muscle, spleen, and now her liver which is operating at 20% and deteriorating fast.
Autoimmune hepatitis? Did you page Foreman? He took up Cuddy's offer of time off.
Normal thyroid means no hepatitis.
Could be amyloidosis.
Amyloid build-up hits the organs, tissue Her muscles wouldn't have atrophied.
You run the echo on the husband? Heart's still failing.
The improvement was only temporary.
I prefer the less subtle answer.
"You were right, House.
" So, less time proving why hubby isn't dead more time proving why Kutner is.
Motives for murder.
House, it was a suicide.
The police have already investigated.
They investigated what they saw, not what they didn't saw.
Talk to friends, classmates, pizza delivery guy.
Draft Foreman.
He can make calls through his tears.
No.
Is that, "No, I'm not calling my boyfriend "who apparently called my boss instead of me to say he wasn't coming in"? 'Cause it's really not fair to have that much subtext in one syllable.
We all want to know why Kutner did it but we're not gonna waste time chasing ghosts.
You're not remotely curious? Only why a man who embraces the rational is suddenly pursuing the irrational.
She could have Alpha 1 antitrypsin deficiency.
Run her AAT proteins.
I'd like to be with Eddie.
It's too soon after your surgery.
You can ask if someone gets your organs if you die, right? Even if the donor bank turned them down? Individual donors can bypass the registry but there are a lot of other factors.
Blood type I've given him blood.
It's not just Please.
If I go before him, I want you to give him my heart.
This isn't over yet.
For me.
But it is for him, isn't it? Yes.
Remy Hadley.
I also answer to 13.
I sometimes sleep with you.
I know I should have called.
I just need some time.
Alone? I've worked through a lot of bad stuff in my life always done it solo.
So I should go? I'm sorry.
Okay.
IT's been trying to close out Kutner's email account.
Apparently, someone's still logged on to it.
Wasn't hard to figure out that his password was "Kutner.
" He did what they tell you not to.
He wasn't murdered.
But his parents were.
And the guy who killed them is coming up for parole.
He's coming up for parole, he's not out on parole.
Kutner testified at every one of his hearings.
Guy wouldn't be the first to see the clock ticking He was killed by his own gun.
Which he bought years ago, obviously for self-defense.
In the temple, cops found residue.
Right.
A murderer would never try to make it look like suicide, that'd be unethical.
You haven't asked about my patient.
You're waiting on AAT protein results.
Means you checked up to see that I'm still on it.
You want to transfer the case but you won't because you think it's the only thing that's holding me together.
Well, relax.
Either I'm right or I'm wrong.
We'll know soon enough.
Find what's killing your patient and then I'll find you another patient.
What happened? Nurses found her like this.
She broke into the cart, injected whatever she could grab.
Dumb way to look worse for Eddie.
She wasn't trying to look worse.
She was trying to kill herself.
She's stable but whatever was left of her liver is definitely shot now and there's no change in Eddie.
So, thanks to her idiotic move she's dead in 24 hours if she doesn't get a new liver.
It was selfless.
She loves him.
How does that disagree with what I just said? Test was negative for AAT deficiency.
Myelofibrosis fits, but testing takes at least 48 hours.
We should try a partial donation from a live donor.
Damage is too severe.
She needs a whole new liver.
No diagnosis, no liver.
No liver, no living.
What do you know? It is myelofibrosis.
Says so right here.
Who wants to tell Cuddy? How many times have you lied to the transplant committee? Just twice.
How many times has it worked? I don't quite see how that's relevant.
Cheese it, it's the coppers.
We're not just gonna leave them to die while you fixate on Kutner.
Technically, he's not our patient so I'm really only leaving her to die.
We've already explored the usual options shouldn't we at least explore unusual ones? Absolutely.
Don't worry, this is why God gave me two ears.
Kutner would say we should just come clean with Cuddy.
Wow, if only he were here to say that.
I'm sure Cuddy would be bound to fall for the old "Hey, the dead guy won't mind that we're wasting" I need an incurable romantic to talk to an incurable romantic.
Kutner wasn't murdered.
You deduce that by removing your sunglasses to the strains of a Who song? Suicide means you could have helped him, murder lets you off the hook.
Needs a liver.
Has a liver.
He can make a partial donation.
The faster he agrees, the faster she gets to not die.
Partial won't be enough, she needs a whole liver.
And he'd never survive the procedure.
Nice symmetry, huh? He dies on the table, you give her his whole liver.
If he's gonna do this, he's gonna do this for love.
Thought he should talk to someone who spoke the language.
You want me to die on the table? We don't want you to.
Your wife needs you to.
My heart? Is still dying.
You have a couple days at most.
But this could buy us enough time to save her.
When can I say goodbye? You can't.
If she knew what we were planning, would she be okay? She'll resent me.
She'll be alive.
Nothing else matters.
You can't do the transplant.
Only if he said no, but your urgent hovering means he said yes.
His fingers have nodules.
I think his doctors misdiagnosed him.
Or you sprinkled too much wishful thinking in your tea.
Obese man with lung cancer.
Two easy explanations for his heart failure.
Nodules could mean something else, something curable.
Go back to the ER.
My thanks to you and your cold feet.
What's going on? I'm giving you a shot at a cool result.
Better yet, a chance to prove other doctors idiotic.
Except you're wrong.
You figure that out by taking off your sunglasses to the strains of a Who song? The guy who killed Kutner's parents died of an aneurysm two months ago.
Kutner hid from everyone.
You didn't get a chance to save him.
No one did.
Run the test.
Find out if you have a chance to save Eddie.
Bad news.
Love can't save you.
On the other hand mold can.
Your heart failure was caused by a fungal infection called cardiac blastomycosis.
Started as nodules in your lungs which every doc, except one, mistook for cancer.
It's very rare, very curable.
I'm starting you on itraconazole.
But how come I was getting better without the medicine? Your emotional state bumps your catecholamines which help raise your prolactin My emotional state? Three months of treatment, you'll be back to your buff, chiseled self.
I don't want the treatment.
Do the transplant.
You'd be trading the certainty that you'll live for the uncertainty that she'll live.
I was ready to die anyway.
Now you get to be nicer to your next wife.
If you won't do it, release me.
And when I get hit by a car and show up in your morgue you can give her my liver then.
You're basically asking us to commit murder.
I was yesterday, too.
There's a difference when he has 20 years to live instead of two days.
Not really, not legally.
That's your way of convincing us to do this by saying it's no more immoral? The idiot is gonna do this with or without us.
This way, we can protect the organ.
We should be protecting him.
So we strap him to the bed, wait till his wife dies? I'm not doing this.
I will.
We've already had one pointless death.
Eddie? What's going on? I don't know.
He just came and got me.
Your husband has a curable disease but he wants to die so he can give you his liver.
Are you okay with that, or would you rather he take the treatment? You son of a bitch.
Eddie, don't.
You have to let me do this.
Charlotte, can you hear me? She spiked a fever.
LP shows her white cells through the roof.
She's infected everywhere.
I should fire you.
I just did what you failed to do.
Convince Eddie to live and let his wife die.
Infection means we have a new clue.
And a full two or three hours to figure it out.
Sarcoidosis.
Hits the spleen and the liver.
She'd have lung issues.
Scleroderma inflames the tissue.
No skin or GI problems.
What is she hiding? You don't know that Either we have all the clues and we're idiots or we don't have all the clues.
Possible exposure.
People, places.
Both.
Bad lie.
Did you really think the beaches in Hawaii were just like the beaches in Rio? The disease-bearing sand flies are completely different.
She's never been to Rio.
Who'd you go with? Why are you doing this? I don't actually need to know who it was I just need to know that you went so we can know that you have visceral leishmaniasis.
But since Lancelot there was ready to die for you he might want the answer to both.
Last year.
It was nobody you knew.
Rio was supposed to be ours.
I got tired of waiting.
I'm so sorry.
Start her on antimony.
Have Cuddy find her a liver.
They were all ready to die.
But for guilt, not love.
You can't feel that much guilt without love.
New York Mercy's medevacing a liver.
It should be here Tell them to turn around.
Charlotte's treatment isn't taking.
We diagnosed it too late.
Everyone's heading over to Kutner's funeral.
You're welcome to ride with me.
I'm going to stay with Charlotte.
She bought you some time to save Eddie it'll give her death some meaning.
No, it won't.
I was wrong about you.
No, you weren't.
You're in pain.
And you're romanticizing.
Again.
You worked with him every day for two years and you never saw this coming.
No one saw it coming.
But you see everything coming.
This has never been about what you missed this is about why you missed it.
You're terrified that you're losing your gift, losing who you are.
And I'm terrified of what you'd do then.
Unless you feel there's more to do here to cure me don't you have the funeral to go to? I'm taking a ride Off to one side It is a personal thing Where? When I can't stand Up in this cage I'm not regretting I don't need a better thing I'll settle for less It's another thing for me I just have to wander Through this world alone Stop before you fall Into the hole that I have dug here Rest even as you Are starting to feel the way I used to I don't need a better thing Just to sound confused Don't talk about everyone I am not amused by you 'Cause I'm gonna lose you Yes, I'm gonna lose you If I'm gonna lose you 'Cause I'm gonna lose you Yes, I'm gonna lose you If I'm gonna lose you I'll lose you now for good
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