House, M.D. s06e02 Episode Script

HOU-603 - Epic Fail

I guess everybody else is dead.
Which means we're totally outnumbered.
We gotta make up for that in pure firepower.
You want to raid the feeding area, don't you? Two boxes of grenades in there.
It's our only chance at getting out.
Vince, that place is a deathtrap.
Lucky for you I've got the megablaster.
Lee, you go right, Roy, straight down the middle.
I'll cover you both.
One, two, three.
Where's that cover fire? Megablaster, dude, megablaster! What the hell? Got it.
Vince, where are you? I can't get them off of me.
Vince, you d-bag, where are you? Damn it! Damn it! Damn it, Vince.
That blood look funny to you? Still working on it.
The code's a little janky.
Hey, boss, you just like watching us get our asses shredded? Yeah, not that you're not hilarious, but we hit the shelves in three months.
Vince? Vince, what's wrong? My hands, they're on fire.
Your NCV test was normal.
Rules out carpal tunnel.
No evidence of trauma, your blood work looks normal.
Then what is it? I don't know.
I'll arrange to have you transferred to a neurologist.
A neurologist? Don't you have some famous diagnostics guy? What's he doing? I quit.
You can't quit.
I think you're confusing me with Jake Gyllenhaal.
House, are you okay? Yeah.
And I want to stay that way.
I talked it over with my therapist.
I need to change my environment, my habits.
But he cleared you to get your license back.
Which will help immensely with my new job in research.
I've sent out some resumes.
Research means no patients, less pressure.
But you just got out, have you had enough time to think this through? I'm sorry.
I know this will affect both of you, and Thirteen, and the one with the nose.
But I just can't risk coming back here.
Okay.
That was surprising.
I want to run the department.
You consider waiting until House clears the lobby before you start angling for his job? He's not dead or sentimental, and somebody needs to do it.
Not necessarily.
Departments of diagnostic medicine don't exist.
The only reason we have one is because of House.
You reassigned us, kept us on payroll for three months, you might as well give me a chance.
You're a great doctor, I want you to stay on in Neuro, but House was a genius.
House was an egotistical, pill-popping, lawsuit magnet.
And a genius.
And I worked with him longer than anybody else.
I can do this.
You get one shot.
What's House gonna do? No idea, but he's gone, so how about we focus on the medicine? What? You're the boss, it's kind of sexy.
Here I thought it was just the pants.
Diabetic neuropathy? HbA1c looks fine.
Could be hypothyroidism.
No fatigue or weight gain.
What about complex regional pain syndrome? That's a good idea.
Let's run with it.
Look at that.
No House, the job still gets done.
And yet, something's missing.
I'm short, he's black, you're gay-ish.
That's it.
Treat for CRPS.
Prep the patient for spinal stimulation.
I don't buy it.
CRPS isn't that well understood, but I think it's mercury poisoning.
I eat a ton of sushi.
And you're currently getting mixed reviews in Speed the Plow on Broadway? Google it.
It's pretty hard to consume enough fish to give yourself mercury poisoning, and it doesn't usually present solely with pain.
But it can.
Check out the Atlantic Medical Journal.
This guy came in with burning pain caused by Erythromelalgia caused by mercury poisoning.
Who needs actual doctors when you've got the Internet? No offense, but doctors make mistakes.
Medical errors are up 30% this year.
You should check the rate of patient error.
There's a ton of information out there.
Why wouldn't I educate myself, be my own advocate? CRPS came up in my search, too, but I've never had any skin discoloration, and my pain is sporadic, not constant.
It's gotta be worth one lousy blood test.
You know how House feels about people touching his ball.
No, Chase refuses to tell me.
Right, my husband's gay.
Witty.
I hear you're taking over for House.
You're gonna be great.
Congratulations.
Not permanent.
Yet.
Taub and Thirteen cool with it? He's older than you.
She's seen you naked.
Not like we haven't been working together for two years now.
Working with is different than working for.
You saw House, how was he? He was good.
He was honest, took responsibility.
It was kind of weird.
Is Thirteen around? I need her to sign off on her ER transfer.
She and Taub are doing a spinal stimulation.
No, they're not.
I just dropped a patient in the cath suite, and your guys were not in there.
You know, usually, spinal stimulation is done with the patient in the room.
He asked us to test his blood for mercury.
It's unlikely, but not impossible.
It's also not what we agreed on.
Testing doesn't hurt, and it only takes I figured it didn't matter.
I'm thinking I should decide when it matters.
If you're done marking your territory Test results.
Surprise, surprise, Marcus Webly was wrong.
I'll handle this.
You expected not to have mixed feelings? I know it's the right call.
I just don't know what to do with my time, and my leg.
Pain's flared up since I left Mayfield.
Ibuprofen's barely putting a dent in it.
You need a hobby.
Right.
Doctors the world over treat chronic pain with collections of Hummel figurines.
No, I didn't say you need a lame hobby.
You need something to keep you engaged, connected to other people.
You already made me get a roommate.
Wilson's got one bedroom.
I don't think we can get any more connected without unzipping.
Okay.
So what does Wilson like to do? Vince, I'm Dr.
Foreman, Head of Diagnostics.
So you must be the genius's replacement.
I prefer to think of myself as Genius 2.
0.
Your blood test ruled out mercury poisoning.
What was my mercury level? Two-point-eight.
That means for every deciliter of blood I know what it means.
I also know it's above normal.
I want mercury chelation.
Your level isn't elevated enough to produce your symptoms.
You can't know that until we de-elevate it and see if my pain improves.
It's a judgment call.
Based on 10 years of medical training? I think you have CRPS.
I want to try spinal stimulation.
So, basically, you want to shove a needle in my spine based on a glorified hunch.
I'll stick with the chelation.
If you don't want to get better, I think we're done.
What do you mean "done"? You're not interested in my medical opinion.
I'll move on to my next patient, you'll move on to a doctor willing to run all the unnecessary tests and procedures you want.
Or you can stick around and be cured.
Makes no difference to me.
I'm glad you changed your mind.
Don't know about that.
Dr.
Foreman basically strong-armed me.
Which is impressive.
Stimulating at 100 hertz.
Guess you found him a little more persuasive than the two of us.
Probably the pants.
He reminds me of me.
Is it supposed to hurt? Not if we're in correctly.
Is it your hands? Your back? No, my chest.
Can't breathe.
Heart rate's 140, climbing.
You need to hold still.
What did you do? Deep breaths.
His lungs are filling with fluid.
Analysis of the fluid from Vince's lungs shows the lung problem is really a heart problem.
He's got a thickened left ventricle.
When his heart sped up during the procedure, it jacked up the pressure in his lungs, causing pulmonary edema.
Good thing I talked the patient into spinal stimulation.
It did lead us to discovering a new symptom, and proved he was wrong about mercury poisoning.
We lucked into that discovery, and we were wrong about CRPS.
Ventricular thickening plus neuropathy could equal Lyme disease.
Not without joint pain.
When's his new game coming out? Couple of months.
He's probably working non-stop.
Might be using more than coffee to power through.
Cocaine use explains his symptoms.
So we search his office for drugs.
No.
We're gonna ask him.
In a lot of ways, cooking is like music.
Different elements combine to make a symphony.
Difference is that Beethoven's Fifth isn't going to be poop tomorrow.
What was my one condition for allowing you to tag along? Try not to be a jerk.
I'm trying.
I'm just failing.
Roll your meatballs and keep an open mind.
How hard are you trying not to make a ball joke right now? They're smoking.
Your balls.
Oh.
No, no.
They're browning way too fast.
Blue's the color you gotta watch out for.
Enough.
God, they're They're still raw inside.
By the time they're cooked through, the outside will be burnt.
I think there's a medicated powder for that.
Although, vinegar could work.
My old chem prof talked about theoretically you shouldn't trust the results of a hemoglobin A1C test on a chronically acidotic patient.
The acid in the blood slows the reaction between the hemoglobin protein and blood sugar.
Browning meat is the same chemical process, which means it should also be slowed by acid.
That actually makes sense.
You might have saved my balls.
That's the spirit! Obviously the procedure didn't go as planned.
The heart problem was unforeseeable, but I still feel responsible.
I'm sorry.
Okay.
How long have you guys been doing it? I think it's best if we kept things professional.
Tough to do, now that I've seen you rock a leopard-print bikini.
Congrats, by the way.
Up top.
You hacked my profile page? Your treatment nearly gave me a heart attack.
Figured I'd check if you had the credentials to go with the cojones, one search led to another.
Is there a shot of just her? I'm thinking screensaver.
We need to know if you've been using cocaine.
Nope.
Dude, you just block everybody or do you really only have three friends? We need you to be straight with us.
We need to be able to trust you.
I cleaned up my act after my college roommate OD'd.
Okay.
Search his office.
You think he was lying? No, but I'm not sure.
It was worth asking.
If he'd said yes, it would've saved us a trip.
But he didn't.
You have to forget about him.
The patient? House.
First you try acting like him, that doesn't work, so then you try the opposite.
Now you're mad because you have to use his move.
I feel like Tom Brady's backup.
Tom Brady's backup now makes $10 million.
Stop comparing.
You can do this by being you.
We should still check out his office, talk to his co-workers.
I'll get Taub.
And thanks.
Oh.
And dinner tonight at 7:00.
Can we make it 8:00? Already made a reservation for 7:00.
Hi.
I'm making gnocchi.
Oh, I didn't mean to intrude, I just Cecile's in my cooking class.
She doesn't speak English.
You bake the potatoes instead of boiling.
Less moisture, fewer gluten bonds, lighter gnocchi.
You seem good.
Feeling better.
House.
I need to talk to you about your leaving the hospital.
I do love a good groveling, but my decision is final.
That's fine, as long as I'm not the reason for it.
I know that sounds completely narcissistic.
Yeah.
But it's not.
We flirted, we kissed, I fondled.
I hallucinated a night with you and yelled it from a hospital balcony.
You're not a narcissist.
So what am I? Not the reason I'm leaving.
House.
I'm gonna miss you.
Lady, either kiss him or leave.
We got work to do.
You just couldn't keep your trap shut.
Make the damn gnocchi.
Bye.
I guess you're not in a hurry to get back to the office.
And you are? I'm not trying to avoid my boyfriend.
I'm a lizard, not an idiot.
You've been in a crappy mood since we got in the car.
And you're completely okay with being ordered around by someone who 24 hours ago was basically your equal? Unlike you, I didn't expect anything different.
The work part I can get used to.
He didn't ask me to go to dinner, he told me we were going.
He's never done that before.
So even the score.
Go home tonight, put on some heels and break him like a pony.
You'll feel much better.
What? That's one big-ass bird.
Wow.
That's kind of amazing, the way the wings move, it's so real.
Get them off me! I know what's wrong with the patient.
I'm going to call Foreman.
A little help.
Your partner said you studied birds to improve the game animation.
Did you touch them? Can't dissect without touching.
It's the best way to understand the anatomy.
It's also a good way to contract an infection called psittacosis.
We spoke to Dr.
Foreman, he wants to start you on antibiotics.
Does that infection cause problems in the joystick area? Kind of stuck in play mode.
Yes, we get it.
She's very, very pretty.
It's not her.
I mean, it was, when she was here with her boyfriend three hours ago.
You've had an erection for three hours? At first, it was just embarrassing, but now it's really starting to hurt.
Will the antibiotics help? I'm afraid not.
This isn't psittacosis.
His erection persisted even with medication.
We had to put in a surgical shunt just to drain the blood.
You missed dinner.
And a shunt doesn't require both of you.
I'm dedicated.
So, the holy trinity, heart, hands, hose.
Could be Guillain-Barré.
Not with normal nerve conduction.
Thrombocytosis.
His platelet count isn't that high.
Brain tumor makes more sense.
I'm sorry, I just realized.
Joint pain and joint pain.
Honest, I wasn't laughing because of the obvious tension between the two of you.
Erection points to a circulatory problem.
I'm with Foreman.
It is possible for a brain tumor to cause We're going with thrombocytosis.
Okay.
You're mad I didn't ask you to dinner? How long have we been dating? It felt like an order.
Your tone of voice was My tone? I'm under a little pressure right now.
How about giving me a break? Look, this is tough for both of us, except I haven't just gotten a promotion.
So, now you're jealous? No.
I'm just saying don't complain about the burdens of command to your employees.
I was complaining to my girlfriend.
Who are those guys? I have no idea.
Meet the competition.
Steve Paulson, Neurology, St.
Mark's.
Nice to meet you.
You called another doctor? Lots of other doctors.
I posted my symptoms on the Internet.
You guys are 0-for-2.
I thought I'd look for some backup.
I can cure all your symptoms with my papaya toxin cleanse.
Month's supply, $395.
Okay, that guy's an idiot.
That doesn't mean they all are.
Neither one of you have privileges at this hospital, please leave.
Now.
Dr.
Foreman, sorry for the intrusion, but I notice you haven't done a head MRI yet.
Because he doesn't need one.
I'm pretty sure he's got a brain tumor.
We considered that and concluded thrombocytosis is more likely.
I'm starting him on hydroxyurea.
His platelets don't seem anywhere near high enough.
If you took an image, I'm sure There are no signs of increased ICP.
I'm not delaying treatment.
Looks like we need a tiebreaker.
Dr.
Hadley, what do you think? I think both theories have merit.
So, brain tumor, otherwise you'd back your boss/boyfriend.
I want an MRI.
Fine.
I'll set it up.
Great, you're up.
I need a taster.
Ragü with pork sausage, beef thigh, no cream.
It's a little early.
Did you even go to bed last night? Bed is for sissies.
Unless you're having sex, in which case No, bed is still for sissies.
Doesn't this seem a little bit obsessive? You should have been here when I was butchering the ox.
What do you expect? I'm an addict, I turn everything up to 11.
Yeah, I thought you were trying to tone that down.
No, I'm just trying to find something I can set at 11 without blowing out my eardrums.
Star anise with the caramelized onions, the sulfur compounds bring out the meat flavor.
I couldn't sleep because of my leg.
It was either make ragü or go out on the street looking to score.
Good choice.
So, so good.
He asked me a question, I answered.
You told me to make my own decisions, I do, and you stab me in the back.
I didn't even say what I really thought.
I hedged, and I don't like that I hedged.
If I have a legitimate opinion You express it in private.
In public, the team opinion is your opinion.
Except the team opinion is your opinion.
That's my job.
And what's mine? To lie when I'm asked a direct question? You would have done it for House.
Maybe you just don't want me to succeed.
Maybe you just want to kick me again for not asking you to dinner.
At least when House was being an unbelievable jerk, I could talk to my boyfriend about it.
I may be a jerk, but you're wrong.
MRI is clean.
Treat for thrombocytosis.
You're early.
For what? I knew you'd show up here complaining about Foreman.
I thought you'd hold out for another week at least.
I showed up to ask if you've seen thromobocytosis with a platelet count under I went crazy, not stupid.
I leave, Foreman embraces his inner Mugabe.
What's that? Embryonali.
Unhatched chicken egg.
I'm going to suck out some of the yolk and replace it with ragü.
By the way, you can tell the other lepers that their absence has been noted.
Cameron didn't come by? Daddy's little co-dependent is all grown up.
Making room for Daddy's hot bisexual with boyfriend problems.
It's not a problem, it's Okay, it's a problem.
I mean, I get it, the patient's a nightmare.
He posted his case online.
You know Foreman, you know the situation.
How can I get him to tone it down? Stop being a coward, for one thing.
He's the one who's afraid of failure.
In a job that no one before me has ever done.
His fears are justified.
You're just afraid of giving him control over you.
Which might work at home, but makes it almost impossible for him to do his job.
Pass me those crackers.
You're saying this is all my fault? I'm saying that you would be happier if you learned when it's okay to give in.
What? You just suggested that I give in so that I could be happy.
What did they do to you in there? Taste this.
Oh, my God.
This might be the best thing I've ever eaten.
And, yes, I'm including what you're thinking of now.
You're an amazing cook! I know.
And yet, my leg hurts.
Fire her.
I'm not gonna fire her.
Then stop being such a wuss.
I am not being a wuss.
Challenging you is part of her job.
But when she does it, you take it personally.
So you're saying this is my fault.
I was trying to bury it a little, but, yeah.
You gotta eliminate either the challenge or the reaction.
Or we could stick with my original plan.
We get drunk and talk about how girls are lame.
Yeah, this problem will go away on its own.
It's 8:00 in the morning.
Coffee ice cream.
No frittata, no bombolini? Started thinking about what you said, about me obsessing.
Started obsessing about obsessing, decided to take a day off.
You were enjoying cooking.
How like a man to think that I enjoy slaving over a hot stove all day while you're off banging secretaries.
You said it was keeping your mind off the pain.
That was before I discovered The Biggest Loser marathon on cable.
I like to pretend they can see me eating.
And your leg? It's fine.
My leg's killing me.
Cooking helped for a while, then I guess I got bored.
My leg started hurting again.
Then I got worried, and that made the pain worse.
What are you worried about? That nothing's gonna help.
That I end up in the Very Dark Place.
I'm fine, I'm just not happy.
I didn't let you out because you were happy.
I let you out because I believe you have the skills to cope with that.
You tried one thing, it didn't work, so move on.
Write, play chess What if nothing works? What if nothing gives me more than a few days before my brain starts looking for the next fix, before my leg feels like someone's shoving nails into it.
What do I do then? If nothing in the world can hold your interest, we'll deal with that when we get to it.
But you have to trust me, and you have to be patient.
I brought you a donut.
The florist was closed.
I'll get a vase and put it in water.
You know I'm sorry, right? I'm sorry, too.
Do you think we could start over? That's a fantastic idea.
We're gonna be late.
Your boss won't mind.
No way.
His lymph nodes blew up.
He's been treated for thrombocytosis, but there's been no change.
I was wrong.
God, you are a genius.
I'm adding this to my list of symptoms.
That didn't work last time.
Because I didn't think big enough.
Now I'm offering a $25,000 reward.
Steroids reduced his facial swelling.
Swollen lymph nodes rule out thrombocytosis.
How did so many people get my personal e-mail? The Internet is a magical place.
Lymph enlargement makes me think polyarteritis.
You were saying? No point in treating the symptom and not the disease.
Your stunt generated quite a few responses.
Let's take a look.
I'm way ahead of you.
Paraneoplastic syndrome secondary to spinal tumor.
No.
No hypercalcemia, no muscle spasms or incontinence.
You are possessed by the Biblical demon Legion.
No.
No jumping off a cliff in a herd of pigs.
Otherwise, it did fit.
Graves' disease.
No.
Thyroid levels are normal.
You want us to spend next few days shooting down every theory in the world, or can we do our jobs and come up with one that works? I want you to test me for amyloidosis.
Is that your professional opinion? It's the wisdom of crowds.
Studies show that collective decision of a group can be more accurate than any individual's decision.
I went through my e-mails, amyloidosis got the most votes.
If you had amyloidosis, there'd be speckling on your cardiac ultrasound.
In 100% of cases? Fine.
I'll make you a deal.
We do a kidney biopsy to test for amyloidosis.
When it comes back negative, you pull your case off of the Internet and retract the reward.
It's either that or I don't test you at all.
Deal.
If you wanted a quickie, you should have called ahead.
I'm a mess.
I came home for lunch.
You have lunch with Cuddy on Tuesdays.
She was busy.
And you're checking up on me.
You know, you can talk to me Is that my laundry? You were running out of socks for me to borrow.
We have plenty of underwear, though.
I'm fine.
You said that this morning.
And consistency proves what? Really, I'm good.
I'll put these in your room.
You always hurt the one you love Biopsy showed deposits in the renal endothelium consistent with amyloidosis.
The Internet was right.
Start him on dexamethasone.
Already done.
This may not be the best time for this, but I quit.
I got an offer to join a friend's surgical practice.
You don't generally get an offer unless you're looking for one.
I put out some feelers when I found out House wasn't coming back.
I lobbied to keep the department open so you could keep your job.
Yes, that was incredibly altruistic of you.
It's nothing personal.
Actually, I think you're doing pretty well.
But I came here to work with House.
He's a jerk.
We'll be fine without him.
Do you know how many resumes we get every day without even asking? Might be a few less after Cuddy shuts us down.
The case got solved under your watch, does it really matter how it happened? It matters.
What if I'm just not ready for this job? Okay, you're sad.
I could tell you the story about me and my roommate at Sarah Lawrence.
Okay.
Her name was Lindsey, and she was a cheerleader from Iowa.
I broke my toilet this morning.
I'll get my tools.
I blocked the intake valve so I could collect some of House's urine.
Cuddy, he was barely limping.
What did the lab say? The urine was clean for Vicodin.
It did however contain strange epithelial cells.
Further analysis showed they were from a Labrador Retriever.
Damn.
He's using.
Vince, Vince.
Vince, relax.
It's Dr.
Foreman.
Kill it! Kill it! No! I don't have my blaster.
He's hallucinating 'cause he's burning up.
Amyloidosis wouldn't do this.
Antipyretics didn't work.
Hopefully the cold tub will get his temp down.
Maybe we should see if anyone's sent in other ideas.
Maybe the reward money attracted No, I'm not letting anyone else jerk us around.
The masses were wrong about amyloidosis.
They don't know about the fever.
I'm going with Light-Chain Deposition Disorder.
You okay with that? Yes.
We think you have a disease called LCDD.
It causes proteins to build up in your organs.
You think? We can't definitely confirm the diagnosis.
And our only chance of beating this would be to start you on high-dose chemotherapy.
But I do have to warn you that in your condition, it might kill you.
Do you want me to get you some more information? You're my doctor, I trust you.
No, you don't.
You're scared, and you don't want to make this decision.
My career is riding on this case.
Nowhere near as important as your life.
But I think the best shot for both of us is to treat for LCDD.
Okay.
All right.
Let's get you out of this tub and into chemo.
We know you're back on Vicodin.
No.
The only thing you know is that I'm a genius who got a dog to pee in your toilet.
You don't know how I did it, or, more interestingly, where I peed.
House, you've spent the last three months Et tu, Butte? You got no reason to be here, he's the one I was jerking around.
Why is your leg better? Ow! It hurts.
Please go away now.
If you really think I'm using, how about asking me before taking a wrench to your plumbing? House, you're an addict.
You can't be surprised if we can't take you at your word.
Fine.
Let's get you some proof.
Hide your eyes, ladies.
House.
You, too.
My godson made me that mug.
If the lab says this is Retriever, too, please let me know right away.
It'd explain my overwhelming desire to wipe my butt on your carpet.
Thank you for dragging me into this.
Stop the chemo, he's got Fabry's disease.
He was in a tub for an hour, his fingers should have pruned, but they didn't.
Already stopped chemo, and confirmed Fabry's.
I'm glad you both agree but could somebody loop me in here? We assumed the deposits in your kidneys were proteins, but they were fats.
Fabry's makes them build up in your organs, choke your nerves, keep your fingers from pruning in water.
It's chronic but manageable.
How did you figure it out? Iodide mumps.
His lymph nodes swelled up after the head CT.
We thought it was a new symptom, but it wasn't, it was a reaction to the contrast.
Iodide mumps takes lymph nodes off the table.
Remove that symptom And that just came to you? I looked through the online responses again.
Someone posted it this morning.
I heard Cuddy made it official.
Department's yours.
Congrats.
I'm sorry.
I went behind your back.
On a scale of one to 10, how mad are you? A seven.
And that's stupid.
You did the right thing.
It's my fault you thought you had to go behind my back.
I should have stood up to you.
But you didn't 'cause you didn't want to fight again.
It's our first case, it'll take time to adjust.
What if by the time we get adjusted, we don't like each other any more? That's not gonna happen.
Are you sure? 'Cause ever since I took this job, we've been making each other miserable.
I really don't think this is gonna work.
You're breaking up with me? No.
The other night, when I thought I was done, you were there.
I need you.
I don't want to lose you.
Then, why are you You're firing me.
I'm sorry.
I slipped.
You took Vicodin? $25,000.
I solved my old team's case.
I was about to take the pills, I went online, I found people posting medical problems.
And my leg stopped hurting.
Oh.
Oh? I'm supposed to be changing my life.
This is not a change.
Maybe I was wrong.
Says the guy making sand castles in my brain.
We need to keep you from using.
Taking your job away, the medical puzzles, nearly drove you back to it.
Maybe diagnostic medicine is the key to keeping you clean.
So you're okay with me going online, solving cases? No.
You can't sit all day in a room by yourself.
Isolation fosters depression.
The hospital is part of my old life.
If I go back, I might become who I was before, pills and all.
That's a possibility.
But could be, the only thing worse for you than going back to diagnostic medicine is not going back.
Guess we're gonna find out.

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