House, M.D. s06e19 Episode Script

The Choice

Hey.
Hi! Car's full of gas.
You sure? And if I'm not? You'll be paying me back for those damn invitations.
Oh.
Well, then never mind.
Ted is a wonderful man, Dad.
He's the second greatest guy I ever met.
Guess that's us.
Mmm-hmm.
Into this holy estate, these two persons present now come to be joined.
And so, if any person may show just cause why they may not be joined together, let them speak now or forever hold their peace.
That's what I like to hear.
Do you, Theodore Philip Taylor, take Nicole Margaret Murray to be your wife, and promise before God and these witnesses to be her loving and faithful husband, in plenty and in want, in joy and in sorrow, in sickness and in health, so long as you both shall live? This isn't funny, Ted.
Ted? Are you all right? Teddy? Teddy! Ted.
Hey.
Hey.
What time is it? Happy time.
I'm still asleep.
Just think of this as a dream.
What about House? I said a dream, not a nightmare.
He's in the next room.
Sound asleep.
Esteban, hope you're getting ready.
Hmm.
I met the neighbors.
Sir, do you know this man? I don't need a temporary.
I need a permanent.
Yesterday.
Please do.
Good morning.
Hardly.
One of my PAs quit an hour ago, and I have to reshuffle next month's schedule.
That's nothing.
I woke up in the wrong bed this morning.
Any bed you're in is the wrong one.
That's not what your mama said.
Oh, snap.
I'll be going now.
To human resources.
He started it.
I was in the neighbors' kid's bed.
Luckily, Esteban still likes sleeping with Mommy.
How drunk were you? About yay drunk.
Are you okay? You shouldn't be drinking at all, much less You sound just like Esteban's mom.
I need you in the clinic.
Sorry, I'm busy.
Tell me you have a case.
You know, even if you don't.
I have a case.
Sounds interesting.
I'll take it.
I owe you one.
Now tell me you don't have a case.
I really do have a case.
We're even.
You guys know how to honeymoon.
This is Dr.
House.
Aphasia and syncope.
He can't speak.
"Aphasia" is Greek for "loss of voice.
" We've ruled out infection, vocal cord damage and stroke.
A lot of guys syncope at the altar.
It's Greek for "having the vapors.
" We ruled out all the common causes of fainting, low blood pressure, hypoglycemia, dehydration.
Don't say "ah.
" Do you know what it is? Roll on your side and lift up your gown.
There's one thing they didn't test for.
A test for what? Faking.
Ow! Test was positive.
I can talk.
I wasn't faking.
My voice just came back right now.
Hey, I'm not the one you have to convince.
I know he wasn't faking.
Boy, if she's buying that, she might just be a keeper.
What about the syncope? Well, that She buying this, too? Why would he fake anything? Kryo podia.
It's Greek for "duh.
" So, you get to keep the engagement ring.
I don't think he was faking.
That's because you're more gullible than I am.
For instance, I don't believe that you called off your open marriage.
I believe your wife called it off, and you called off telling her that you weren't calling it off.
Guy doesn't throw a golden ticket in the trash.
Same way a guy doesn't give up a lucrative medical practice to come work for you? That's exactly why you dabble.
You're compensating for your professional conquests with sexual ones.
I'm not that predictable.
For example, you're probably not expecting me to ask you out for dinner tonight.
No, thanks.
You won't even consider it? I did, just very quickly.
Truth is, since I called this thing off, my wife has been very grateful, and I could do with a down night.
If I go out with the boss, nobody can blame me.
Okay.
If you bring your wife.
No, that's the point.
I need a little You're lying.
I'm not lying! Then I'm not going.
Okay.
Fontina at 8:30.
You believe me, right? Of course, I believe you.
Then let's do it.
We'll tell the cab to take us to AC right now and get it done.
You're serious? You just walked out of the emergency room.
Exactly, I walked out.
I feel great.
Well, we do have the clothes for it.
Ted? What's wrong? Are you What's wrong? Oh, my God.
Can somebody help us? Please! Please, hurry.
Just breathe.
Oh, my God.
There's gotta be a better way to call off a wedding.
A tweet, for example.
Pleural effusion.
You think his lung is faking it? There's at least 200 cc's of fluid in there.
Okay, let's say all his symptoms are real.
Explain how one of them suddenly went away without using the words "virgin" or "Mary.
" If the pleural effusion's caused by something systemic, it could explain his other two symptoms.
So whether you believe him or not, all we have to figure out is what caused the PE.
ER ruled out infection.
Eosinophil count ruled out parasites.
And medication he's not telling us about.
You really don't trust this guy, do you? I don't even trust the ER.
Let's rule out infections ourselves.
Tap his lung, send cultures, run cytology for cancer, and check his blood pressure.
We already This time, talk about nuptials while you do it.
Check his home for everything else.
He just moved in with his fiancée three months ago.
Toxic exposure could take longer than that to manifest.
You check his love nest.
You two check his swinging bachelor pad.
That somebody else now lives in? I assume so.
Not the glass! Place looks like 1960s? Could have lead paint.
You think a 27-year-old has pica? If it gets us out of here before the owner comes back, yes.
What did you tell that cute physio? That I changed my mind.
No, you didn't.
You're more nervous than usual.
Because this B&E has actual B.
What That's a suspended ceiling.
What are you doing? I want to see what's above it.
More ceiling.
Made of Asbestosis, I like it.
I'll be in the car.
What the hell? It's okay.
We're doctors.
Nobody was home, so we Well, I'm calling the police.
Do you know Ted Taylor? He used to live here.
Yeah, what about him? He's our patient at Princeton-Plainsboro.
Is he okay? We think he may have asbestosis from your ceiling tiles.
They're not asbestos.
I had them checked when I moved in.
How sick is he? Is he a friend of yours? He was.
Actually, he was my boyfriend for three years.
I'm not gay.
- Really? 'Cause it would certainly explain the cold feet.
Oh, and the boyfriend.
So you're bisexual? No, I'm straight.
Cotter, the guy you met, he's gay.
He had a crush on me.
I left.
After three years? It's possible.
Doesn't mean you're gay just because the guy you're sleeping with is.
We weren't sleeping together What's this got to do with anything? Lung tap turned up mononucleosis.
ER doesn't routinely test for it.
It explains the PE and can be virtually asymptomatic.
We got to wondering, how does a 27-year-old get mono? You're a little old for the kissing disease unless your immune system is compromised.
If there's been any unprotected sex, we'll need to test for HIV.
There's been no sex of any kind.
Okay.
I'll go test your fiancée for HIV.
She the curious sort? Wait.
There may have been some contact.
But I'm not gay.
Sodomy, one of the top 10 most common household accidents.
I did a lot of stupid things, but I turned my life around.
I'm as straight as any of you.
You don't have to believe me.
I'm just saying you can test me as long as you don't tell Nicole.
What business is it of hers? I don't see anything wrong with him marrying a straight woman.
How about it'll make them both miserable? Just like most straight marriages.
He's got the right to life, liberty and unhappiness like the rest of us.
Absolutely no reason to look at me.
I'm not saying it's a great choice.
Just saying it's his choice.
But it has to be hers as well, which it can't be as long as she doesn't know he's gay.
Which is how it's gonna stay since we have no right to tell her.
Like you've never bent the rules.
You date guys.
You date girls.
I assume, at some point, you're gonna make a choice.
I don't lie about who I am.
Patients lying never bothered you before.
Patients weren't lying about their sexual orientation before.
So you're only judgmental when it gets personal? Does it bother me that people hurt others because they're too weak to face the truth? Yeah.
Sorry about that.
Tell me she's not looking at me.
He's negative? Yep.
Looks like being gay didn't make him sick.
So maybe being straight did.
Test was negative, no HIV.
Told you.
What you didn't tell us is how you turned your life around.
That can be pretty hard.
It was.
Downright impossible on your own.
I talked to some people.
It was more than just talk, wasn't it? I know this is personal stuff.
I'm here to help you, not out you.
I had therapy.
Conversion therapy.
Went to a camp for three weeks of intensive rehabilitation.
They injected him with emetics while he watched gay porn.
Apomorphine? Or lithium chloride, or cyclophosphamide.
He doesn't know.
And when that didn't work, they shot him up with male hormones.
A chemical assault like that could explain the PE.
And the ECT explains the rest.
They gave him electroconvulsive therapy to make him straight? To zap the fabulous right out of him.
Neural damage accounts for the aphasia.
ECT doesn't cause neural damage.
Unless it was done at Dr.
Liberace's He-man Quackery Camp.
Run an EEG.
See if they straightened him or just scrambled him.
Sorry, I completely forgot.
My wife just started a ceramics class Tuesdays at 8:00.
It's a half-hour drive from here.
She won't be back till 10:30.
She's taking it with her girlfriend, Marly.
She hopes to make a tea service.
You want to call her? No need.
I already texted her.
And here she is now.
I think you're still seeing the physio.
You got a backup suit in your car.
Don't wanna be bringing home da stank.
Okay, yes.
You're right.
About everything.
But please, House, don't tell her.
Hi, Rachel.
Hi, Dr.
House.
I didn't know you'd be here.
Hi, honey.
Got your text, obviously.
I'm just leaving.
I got a ceramics class.
Really? I love it.
Even managed to talk Chris into signing up for one.
Of course, he's in the beginners' class.
You're in a ceramics class? Friday nights, right? Friday nights.
Sounded like fun.
You should join Chris's.
You know, I should.
Well, gotta go.
Making a tea service.
Hi.
I must've fallen asleep in the lounge.
What are they doing? - An EEG.
What's it for? We're looking for neurological damage that could've caused his symptoms.
Damage from what? A head trauma.
He had an accident? It wasn't an accident.
It was before he met you.
What happened? Was he hospitalized? You should ask him about it.
They have the results.
Everything looks normal.
Look at this.
Beta waves are spiking.
What's that mean? I'm not sure.
He's coding! Crash cart! What's happening to him? He's having a heart attack.
Charging.
Clear.
EKG showed no abnormalities.
So what caused the arrest? Four ways to stop a heart.
Electrical problems, restricted blood flow, blood where it shouldn't be.
Shocks, blocks or bleeds.
I think that's three things.
And cheating.
No, sorry, that's how you break a heart.
I found a ceramics class in Trenton on Friday nights that was full, so my wife couldn't join me.
EP study ruled out shocks.
Now you just have to find some Pottery by Taub.
The lamer it looks, the better.
So we'll do an angio to see if it's blocks or bleeds.
You should be a doctor.
I'm going to check out this new lesbian bar tonight.
Your life is awesome.
You wanna come? I was telling a 33-year-old woman that she has breast cancer.
No, you weren't.
How do you know? Because if you were, you'd need to see the pain in her eyes so she can see the concern in yours.
Why are you setting me up on dates with my team? Taub asking me out was quirky, but Thirteen doing it is a barking cat.
I'm doing it to help you.
By setting me up with a hottie that I can't sleep with? And Thirteen? I've been spending more time with Sam.
I know it's been hard on you.
I figured if you had some company I don't need your help.
Then consider it helping our neighbor's four-year-old.
I gave him a dollar.
How much did you have to pay? Nothing.
I just told them you might be feeling down, and it was in their self-interest to keep you company.
A hundred bucks.
Foreman held out for 200.
House, I'm worried about you.
You could've ended up in jail or worse.
Racking you with guilt.
So I do something really stupid, and you reward me.
Read any parenting manual.
That's not helping me.
That's helping you.
Fine, I did it for me, for my relationship, out of pure self-interest.
Okay.
You'll do it? For you.
Thank you.
It's not gonna work, though.
Maybe.
But how bad can a night out at a lesbian bar be? Hey.
How are you doing? Heart attack at 27.
They said you had a head trauma? I fell off a stepladder and hit my head.
It was a stupid accident.
An accident.
We need to prep you for your angio.
Valium will help you relax.
We're gonna run a line through your femoral artery.
Ted? He's having another heart attack? I don't think so.
His heart rate seems normal.
Are you okay? You weren't discussing wedding plans, were you? No.
I guess I just Fainted.
POTS.
Postural Orthostatic Tachycardia Syndrome.
BP plummets when he's upright, reverts to normal when he's lying down.
He was lying down both times we took his blood pressure.
Protracted hypotension could have induced his heart attack.
Also explains his syncope.
And his aphasia.
He was upright, then you laid him down on the bed to test him.
BP reverted to normal, voice came back.
Jabbing him with the needle had nothing to do with it.
POTS can be brought on by viral or bacterial infection such as mono.
So load him up with fludrocortisone.
You didn't read your ceramics course description, did you? Yeah.
You did? As I'm sure your wife did.
So we all know they're doing a Fourth of July theme.
She'll be expecting something star-spangled.
Nicole? Yes.
Cotter Macklin.
I'm an old friend of Ted's.
Hi.
How's he doing? He had a heart attack.
Oh, my God.
They have him on some new meds, really knocked him out.
Well, how are you holding up? I'm okay.
Thanks.
I brought this for him.
That's his favorite thing in the whole world.
I know.
You weren't at the wedding, were you? No, I wasn't invited.
Ted and I had a falling out.
How did you know each other? We met senior year of college.
Yeah, we shared a house for a while.
You were roommates.
For three years.
I'm sorry.
I just miss him.
I think you should leave.
I shouldn't have done that.
Now.
Please? I hope he gets better.
Hey.
How are you feeling? Mmm.
Don't know yet.
Your numbers look good.
We're gonna keep you on these meds.
You had a visitor while you were asleep.
Oh, yeah? Who? Cotter.
Who is he? I shared a house with him after college.
I don't know why he would show up.
That's it? Yeah.
Why? What did he say? I need to hear it from you, Ted.
One night, I got really drunk and I went to bed.
And he came into my room, and one thing led to another.
The whole thing was a mistake.
Are you saying you had sex with him? I was drunk and confused You're gay? No.
I thought I was.
I even made up my mind to tell my family.
I stood in front of the bathroom mirror, psyching myself up.
But all I could see was disgust.
And that's when I realized I didn't hate the thought of admitting I was gay because I was ashamed.
I hated the thought because I wasn't gay.
And that was the day I went to get help.
So you're not gay? They cured me, Nicole.
That's what all the head trauma is about.
I'm sorry I didn't tell you, but it's all in the past now.
It doesn't matter anymore.
What is it? Oh, my head! He's got severe headaches.
So do I.
Should I call or raise with a double gutshot draw? Nope.
What about infection? That's what we're thinking.
Cerebral infection would explain the headaches, could've caused POTS.
If it's fungal, could've spread to the heart.
I was talking about you.
Has the little gent been wearing a tent? Remind me why that has anything to do with you.
A distracted person makes a distracted professional.
And destroying my marriage will help me focus.
Probably.
Do a spinal tap, run the CSF.
Still talking about you! But you can do it on the patient, too, if you want.
What about her? The bartender? She's the only one who's not here for fun.
Trust me, she's not straight.
If your gaydar is so great, how come you didn't know about the patient till you met his boyfriend? Guy walked in with his bride, it took me awhile to rotate my dish.
It's unbelievable what he's doing to her.
You don't think he loves her? He may love her, but he needs to have sex with other men.
Taub loves his wife, he needs to have sex with other women.
Yeah, it sucks what he's doing to her, too, but it's hardly the same.
To be faithful to his wife, our patient has to deny his identity.
Taub just needs to Has to resist the biological imperative.
It is easier to say no to dessert than to pretend you don't eat.
Says someone who's obviously never been on a diet.
My life's a breeze.
You're successful, smart, and you attract everything that moves.
If you wanna focus on the fact that you're not gonna see 50, that's your choice.
You know what? I agree with you.
My self-pity's optional.
What about yours? Yeah.
CSF was negative for infection, and his headaches are worse.
We were just talking about you.
Please don't.
It's not POTS, we're back to square one.
Not quite.
You did a spinal tap and the headaches got worse.
We're maxing him out on morphine.
He sprung a leak.
He's losing CSF from the tap site.
We made his headaches worse? Just you, actually.
That still wouldn't explain why he got the headaches in the first place.
Low pressure in his brain caused the POTS, not the other way around.
Patch the leak, top him up with artificial CSF.
There.
That should stop the leak.
You should be feeling some relief soon.
I spoke to my parents.
How are they doing? They're still worried.
Well, tell them not to be.
Everything's going to be okay.
Ted? What's happening? He's stroking.
Both eyes are responsive.
Tell me your full name.
Theodore Philip Taylor.
This isn't a stroke.
Then what is it? What's happening to me? It's really not POTS, we're really back to square one.
So what's masquerading as a stroke? Voted the worst Halloween costume, by the way.
MRI showed no problems with blood flow to the brain, rules out TIA.
Sarcoidosis? Chest X-rays showed no hilar masses.
Any luck with the pottery? Wasn't easy.
Bought a suitably cruddy set of fife and drum napkin rings online.
Scleroderma? Skin's fine, ANA was negative.
So what'd that set you back? Too much.
I got into a bidding war with some lunatic.
Histoplasmosis.
EIA was clear.
But, hey, could've gone a lot higher than $215.
You're KissMyAsthma99? What about MELAS? Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes.
NILLAS.
No, idiot, lactate levels are stable.
We're missing something.
We've run every test that makes sense, asked every question we can think of, gone over his history a dozen times.
We know how much we can trust his history.
If history's written by the victor, how do we find out what really happened? Talk to the loser.
Call the boyfriend.
Let's get them all in the same room.
Or we could question them separately and not torture them.
Or we could get them all in the same room and get the truth.
Oh.
Drinks are on me and Foreman tonight.
Can't.
Pap smear.
We don't want to do it either, but Wilson already paid us.
It's going to suck.
I know.
Where and when? Any incidents of dizziness? Seizures? Blackouts? Other than our wedding day.
Don't you think I would've told you if there were? My sister's birthday.
I was drunk.
You had one martini.
On an empty stomach.
Look, he was just sitting on the couch, and then he fell over and that was it.
Once I slept it off, I was fine.
Well, I stayed up that night, checking on him every 15 minutes.
What about sex? Yes, I have sex with my girlfriend because I'm not gay.
We have sex.
Thank you.
No problems? Well, there have been some issues.
Nic Erectile dysfunction? Every guy has it sometimes.
We never had that problem.
Gee, that must be because Ted doesn't like girls.
Or because it's vascular.
I know we did an MRA, but arterial disease causing acute ischemia could explain the heart, neuro symptoms, maybe even POTS.
Might I suggest a diagnostic test? A penile plethysmograph measures changes in blood flow in your penis, tells us if there's a circulatory problem.
You just need to be in the right state.
What's your pleasure? I feel terrible, I don't think anything's gonna work.
Then we'll have to give you a shot.
Where you don't want to get one.
Shot it is.
He kept dreaming Dreaming That someday he'd be a star Superstar, but he didn't get far But he sure found out the hard way That dreams don't always come true Dreams don't always come true Oh, no No No He's leaving Leaving On that midnight train to Georgia Leaving on a midnight train Yeah, said he's going back to find Going back to find A simpler place and time Whenever he takes that ride Guess who's gonna be right by his side I'm gonna be with him I know you will On a midnight train to Georgia Leaving on a midnight train to Georgia I'd rather live in his world Live in his world Than live without him in mine World His world His tears My world His and hers alone I've got to go, I've got to go, I've got to go His and hers alone Nobody wants to follow that.
The night just keeps getting better.
To Wilson.
Wilson.
Wilson.
Everything looks fine.
You sure? Medically, that's good news.
You feeling feverish or sweating? No, I feel lousy, but I don't know why I'm sweating.
What is it? You're not sweating.
You're lactating.
If he can't tell his fiancée he's gay, how's he going to tell her he's pregnant? His therapists loaded him with hormones.
Male hormones don't make you lactate.
Except they can screw up your thyroid.
That was over three months ago, we just started milking him last night.
So something else screwed up his thyroid.
Graves', Hashimoto's No.
TSH was normal.
Pituitary tumor.
Could also explain his libido and heart issues.
And if the tumor's big enough, his headaches and syncope.
Except we cleared him for cancer.
Didn't say "cancer," prolactinomas can be benign.
Check his prolactin level and MRI his pituitary.
Sounds like you had fun last night.
You believe Chase? I believe Foreman.
And they had fun with you.
What happened? I realized that they could be my friends.
You're serious.
And then I sobered up.
You weren't that drunk.
You managed to find your way into your own little bed last night.
I think I sleep better in rocket-ship sheets.
No.
You want to blame this on the booze, but that's easy.
Change is hard.
And wisdom is knowing the difference between what you can change And what you were born with.
And cowardice is labeling what you don't wanna change as innate.
I was winning this argument.
Pituitary MRI Was normal.
How are the headaches? Terrible.
Give me your head.
What the hell? I know, it's the first time you heard that sentence with a possessive pronoun.
Oh, wow, that's better.
Okay.
Enough.
How cool is that? You have a Chiari Malformation, a narrowing in the base of your skull that can cut off CSF flow.
But it wasn't a problem until the ECT at Breeder Boot Camp caused your brain to swell just enough to plug the opening.
And when your brain pressed up against your pituitary, it signed you up for La Leche League.
You still won't be pitching a tent for your lady, but that's just because, you know, she's a lady.
Its orthostatic effect was mimicking POTS.
It also does an uncanny Christopher Walken.
Unfortunately, if you treat it like POTS, it gets worse.
So, as far as that goes, oops.
Proper treatment is surgery.
We'll get you in right away.
So, how did I get this thing? Overbearing mother.
Kidding, CM's congenital.
Like so many other things, you were born that way.
Thought you might be running low, so Thanks.
I'm not coming back.
Ted, this is a mistake.
I know you're hurting, and I'm sorry I'm talking about hurting her.
I love her.
Ted Thank you for your support.
We both really appreciate it.
Good luck.
Hey.
You know what I've been thinking? It's your birthday in three weeks.
What do you say we re-book the church and make it a doubleheader? I don't know, Ted.
Less than a week ago, we were standing at the altar perfectly happy.
Nothing's changed.
Really? I still love you.
Do you still love me? Yes, but Then that's all that matters.
But I think that you still love him.
I'm not gay, Nicole.
I promise you.
How can you promise me that? Because I believe that we get to choose how we live our lives.
And I've made my choice.
So now, I have to make mine.
I'm so sorry.
Nic I'm sorry.
Nic! No.
No.
I'm not saying goodbye.
Yeah.
I want to marry you! I have to marry you! Nic.
It's Friday night.
I called it off.
For real this time.
Frees you up for the next one.
One day at a time.
Napkin rings.
My way of saying thanks.
For trying to wreck your marriage? For trying to save it.
And I get napkin rings.
Expensive ones.
I hired a replacement for my PA.
She seems great.
Good work.
You, too.
Your patient's going home tomorrow.
He doesn't have a home.
You want to grab a bite to eat? So Wilson got to you, too.
No, this is just me.
Lucas? Working late.
I'm buying.
Not that hungry.
Okay.
I just want us to be friends.
Funny.
That's the last thing I want us to be.

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