House, M.D. s06e21 Episode Script

Help Me

A crane collapsed in downtown Trenton.
Don't care.
My great-grandfather.
No, it's just a book he wrote.
Open it up.
Seriously? You're giving this to us? It's a big step you're taking.
I wanted to congratulate you.
I understand that's the adult thing to do.
How did you know? I've known for a while.
The fact that you decided to cohabitate is not exactly a spoiler.
Unless my intel is wrong.
Trouble in paradise? We have to get to Trenton.
Somebody, help me.
Can you hear me? Hmm.
Did that sound like a "yes"? Sir, we have to get you to the OR.
You have a bad wound, but we're gonna pack it and transport you as fast as we can.
Skull fracture.
Glasgow Coma score of 11.
She's immediate.
Move on.
This guy's dead.
His wounds aren't so Forget the wound, look at his toes.
Atherosclerotic emboli.
He'll never survive the surgery.
Maybe his shoes were too tight.
It's not the shoes, skin shows smoker's facies.
He's not gonna make it to morning.
He'll just take up an ambulance ride, surgeons' time and an ICU bed.
He's expectant.
Leave him.
I only nodded off for a second.
I lost control of the load.
I'm so sorry.
Don't worry.
We're gonna get you out of here.
I'm sorry.
He's secure.
- Ready? Three, two, one.
Crane operator.
He made it through amazingly well.
Lucid and responsive, stable fracture, right humerus.
Haven't gotten to his lower half yet.
Tell me when something hurts.
I fell asleep, killed all those people.
Something other than your conscience.
Is that a pill in your pocket or are you just happy to have a tiny, pill-shaped penis? Caffeine pills.
You fell asleep taking these? I drank two cups of coffee, too.
Is that normal for you? No, I hate coffee.
I'm working on no sleep.
My daughter has the flu.
This much caffeine for a coffee virgin There's no way he fell asleep.
He passed out.
Which means a neurological disorder caused the crash, not fatigue.
Hey! We're taking the crane operator back to Princeton.
They said he was barely hurt, he can wait.
Steal an ambulance and call the team.
Tell them we've got a case.
House, no.
I need you here.
But he needs me there, and he moans louder than you do.
There were over 100 people in that building, only 76 have been accounted for.
Foreman and your team can handle the crane operator for now.
Having fun down there? Lots! Every time Cuddy leans over a patient, it's another opportunity for a downblouse nipslip.
What's going on between her and Lucas? Besides them moving in together? That's not enough for you? I gave her the housewarming gift earlier, and she paused for a split second, like she was hiding something.
It's probably her moral revulsion at housewarming gifts.
Or maybe she didn't want to accept a gift for something she wasn't gonna do.
You actually think they're not moving in together? What was that? You okay? Yeah.
Vending machine collapsed.
She still using your ex-wife as her realtor? As far as I know.
Well, know a little farther, will you? Look into it.
Hey! Somebody down here! If you can hear me, tap three times or call out.
Is anyone there? I'm not getting anything.
I heard something.
There's got to be a void down there.
There's a million voids down there, it was the parking garage.
But our equipment hasn't picked up any movement, dogs haven't picked up any scent.
There's smashed cars down there, you don't think that gasoline could throw off their scent? We gotta get back to work, okay? We'll get to this area soon.
Excuse me.
Anybody hear me? Hey! Can anybody hear me? Help me.
What's your name? Please My husband's gift I was supposed to pick it up at the framers.
It's on Elm.
You should have told me earlier, I could've picked it up on the way.
What's your name? It's a picture from our Tortola trip for his birthday.
I'm not asking your name because I wanna become friends.
I'm trying to gauge your mental state.
Hanna.
Okay, that's a start.
What day of the week is it? Tuesday.
Better still.
What happened? You know that giant construction crane next door? It's kind of on top of you right now.
Okay, I'm gonna try to pull you out.
Ow! My leg! Okay.
Okay.
I really need to get help.
No.
Stay.
Someone else will come.
No one knows I'm down here.
Please! Stay with me! Don't leave me in the dark! I'll be right back.
No! Don't leave me in the dark! Please stay! He's still in the ER, House.
We haven't had time to start a differential.
Perfect, we'll start right now.
Put me on speaker.
What causes syncope? Your guy's stable.
The two dozen other patients Don't need to be diagnosed, they just need to be bandaged.
What causes syncope? Vasovagal reaction.
Meningioma, sick sinus syndrome Or you're wrong and he just fell asleep.
How's he gonna sleep with 50 cups of coffee going through his veins? Were you never a medical resident? I hear Ten, Eleven and Twelve.
Where's Thirteen? She's not here.
And answer to your next question is, "I don't know where she is.
" Do you have the answer to my question after that? A space-occupying lesion in his brain is most likely.
MRI will prove I'm right.
Or it'll just prove he suffered head trauma from the crash.
Which we'd want to find anyway.
Two birds with one scan.
Do it.
Having trouble finding a vein for Hanna's IV.
Is she getting weaker? Paler? No, no, she's stable.
That means her blood loss is minimal.
It buys us some time.
Get the IV into her tibia.
It's almost hollow, feeds into the venous system.
Which they, obviously, don't teach you in EMT school.
This side's still leaning pretty bad, got to shore up this beam.
What do you got? We need six 4X4s Told you I'd be back.
Heard you might be thirsty.
I assume that bodes well for the rescue.
Structural beam, high-compression concrete.
I can't break it up.
You can't get me out of here? No.
Just means we're gonna move on to a different piece of equipment.
I got airbags coming in that'll lift 70 tons.
What's your name? You testing my mental state? If I'm gonna be stuck down here for a while, I'd like somebody to talk to.
Look, the guy who just left is the one who's gonna be holding your hand through all this.
You can talk to him.
Little pinch.
Ow! Ow! Okay.
Big pinch.
I got to call my husband.
Can I use your phone? No bars down here.
L'chaim.
Where're you going? Don't worry.
Fire Marshal Bill will be back soon.
So, I hope I didn't weird you out, giving you that gift.
Can we talk about this later? Of course.
Is now later? Maybe things aren't going so well with Lucas? If so, I'm sorry.
I didn't mean to step into anything.
There's no problems.
We're doing just great.
Thank you.
So why the weirdness? Can you help? When I opened it, I didn't think it was a housewarming gift, I thought it was an engagement present.
It just happened last night.
No wonder you'd wanna hide this from me, since I'm such a delicate flower.
I didn't know what to say, and I've been slightly distracted.
That might make sense, except you're not wearing the ring.
So you are hiding it, which begs the question House, it's in my office drawer because I knew I was coming here.
It's not weird, there's no mystery.
I'm just getting married.
Excuse me.
How much longer? Less than a minute.
Are you in any pain? Nothing new.
Just a little claustrophobic.
Shouldn't you be taking care of those other people? The ones that I hurt? Everything checks out okay.
My nose is bleeding.
It's expected, given the trauma you've sustained.
That's not expected.
The way things fell, this support beam is now holding up a giant pile of rubble.
We can't lift it without jeopardizing everyone down here.
So it's time to discuss amputation.
No.
Please listen to me.
You've been down here almost two hours.
By the time they clear away the rubble We're not cutting off her leg.
You don't have to rush to this to make his job easier.
You kidding me? We leave the leg pinned, we're risking crush syndrome.
What's that? Your leg isn't getting enough circulation.
The longer it's pinned, the more the muscle dies.
So what does that mean, like a limp? Dying muscles release poisons.
We free your leg, the poisons rush back into your system.
It could stop your heart.
So could cheeseburgers.
Just get your lazy friends to start moving that pile.
She's got two more hours before crush syndrome could possibly set in.
We're digging up there by hand.
I can't guarantee I can get 10 tons of debris pulled off in two hours.
Well, you need to try.
It's my leg.
It's not just crush syndrome you got to worry about, okay? There's gas leaks, there's fire, we can never rule out secondary collapses, no matter how much we shore this thing up.
You think chopping off someone's limb inside a pile of dirty rocks is safe? Sepsis, fat embolism, hemorrhage Those risks are nothing compared to the risk of this thing coming down again.
Captain, he's a jerk, but that's what the patient wants.
Can we please just give it a couple more hours? Yeah.
I got to get up to triage.
Thank you, Doctor.
House.
You don't need to thank me.
It just makes sense.
Just promise me you won't let them cut off my leg.
I promise.
Does that make you feel better? For some reason, it does.
Your phone is working down here.
Switched carriers, better rollover minutes.
Talk.
MRI was clean, but afterwards he started bleeding out of his eyes and nose.
So there was something wrong before the collapse.
Unless it's just conjunctive coagulopathy from the trauma.
Yeah, yeah, you don't think he was sick before, we get it.
You're wrong.
Brain infection? Sorry I'm late.
Where were you? - Physical therapy.
I left my phone in my locker.
The infection causes neurological symptoms, goes systemic, and DIC causes the bleed.
Good theory.
Except for the part that there's no fever.
Get an X-ray venogram.
See if you can find a reason for your existence.
Also look for venous sinus thrombosis.
We would've seen it on the MRI.
Not if you were too busy not looking for it.
We should X-ray for a facial fracture first, this could all be simple trauma.
Just do what I tell you.
I'll be back in 10 minutes.
You're leaving? There's a dozen people here who can save you.
I'm apparently the only one who can save this other guy.
Wait.
Don't go.
Hanna's freaking out.
She's having a panic attack, she can't breathe, she's gonna rip out all her IVs.
So calm her down.
She wants you.
I'm flattered.
Give her oxygen.
They won't let O2 down there, fear of explosion.
You have to go back.
She needs you, House.
You only came back because I freaked out, right? Not at all.
I just realized how big and scary the world is, and how cozy and safe this little place is.
Thank you.
I'm sorry I needed you.
Here.
Call your husband.
Charlie? I'm here in They called you? They're helping me.
Are you coming? I don't know how this could've happened.
It's your birthday.
I'm so sorry.
See, this is why I lied about the phone.
Your BP is spiking, so you're bleeding faster from your leg wound, and we'll have less time to save it.
Hang up.
Okay.
Okay, they're telling me I have to go.
That was stupid of me.
It was nice.
I don't see that as a contradiction.
He was already on his way.
He was in Baltimore and they all saw it on the news.
How many people were hurt? What did I tell you about not raising your blood pressure? Can I ask what's wrong with your leg? Crane fell on it.
Small world.
You could've just said no.
I'll remember that for my next human contact.
Would you pray with me? No.
I'm not in the habit of encouraging my patients' superstitions.
How's that a habit? You plan on getting trapped under a building again? I don't believe in God.
I don't either.
Please.
I always thought if I did the right thing, if I treated people right, then good things would happen to me.
Do you think that's how it works? I didn't use to.
Then recently I tried.
Now I don't know.
Good news.
Advancing catheter through interior jugular vein.
You told House you were at therapy.
Did you transcribe the entire meeting? Entering the cavernous sinus.
Your therapy's on Thursdays.
It got rescheduled.
Injecting dye.
Really? I'm not gonna rat you out, we're friends.
I just wanna make sure you're okay.
No filling defects.
Don't worry.
I'm okay.
Do you think we could be friends when I get out of here? Yeah.
We'll catch a ball game or a group sex show or something.
Put it in there.
Okay, when the beam starts lifting, you're gonna feel pain.
It's gonna be like your foot's gone to sleep times a billion.
You'll notice that I'm waiting till now to tell you.
We're ready.
Lifting.
I'm feeling the pain already.
That's good.
Means the pressure's coming off.
Closer to getting out of here.
Come on.
Help me pull her out.
Come on.
It's moving! Hanna! Hanna! What the hell happened? I think the adjacent beam snapped during the lift.
Mayday! Mayday! Mayday! We got a secondary collapse.
We're all right, how are you guys? Rescue 1, copy the mayday.
Main tunnel looks fine.
Red Team is on the way.
Lift this up.
One, two The kit.
Give me the kit.
All right.
No breath sounds on the left side.
Tension pneumothorax.
Hey, Hanna.
One of your lungs has collapsed.
I'm gonna have to reinflate it, okay? Hey, you better get back up top, make sure you didn't nick an artery.
I'm gonna have to go.
It's okay.
You're all right.
You're lucky this isn't worse.
You know who's even luckier? You and just about every other human being who wasn't down there.
What did the venogram say? Clean.
Now the guy is starting to spike a fever.
Subarachnoid bleed.
Meningitis? He didn't say his neck was sore.
That's because everything's sore.
He just took a 15-story swan dive into concrete.
Do an LP.
We also have to consider other infections.
So you're suggesting we do an LP? I guess I am.
Genius.
Hey, bad news.
Because of the collapse, we can't try the airbag again until we get everything off the top.
Be five, six hours, at least.
Then we have to amputate.
No.
It's been four hours already.
It used to be a long shot, now it's crazy.
Crush syndrome is basically a build up of potassium.
If we remove potassium We're already treating with sodium bicarbonate.
Not with glucose and insulin.
We got glucose in the kit, there's got to be a diabetic here somewhere.
You want to dose the insulin here? In a non-hospital setting? That is insane.
It's not worth it.
Really? Because I think I'm the only one here who knows what a leg is worth.
And fortunately, you're not the one who's in charge, he is.
And he knows that I'd testify against him if Hanna sues for cutting off a leg without exhausting every option.
Give us a minute? I know you're angry, but please don't put her life at risk just to get back at me.
Really? Wow.
So this is all about you now? You took her side against me right after you heard about my engagement.
Yeah, that must be it.
It's not that you're a pathetic narcissist.
I don't love you.
So just accept it and move on with your life instead of making everyone miserable.
That's great.
A life lesson from a middle-aged single mom who's dating a man-child.
Screw you.
I'm sick of making excuses for you.
I'm sick of other people having to tiptoe around you and make their own lives worse while they try to keep you from collapsing.
I'm done.
Fantastic.
Just stay away from my patient.
What are you clinging to, House? You're gonna risk her life just to save her leg? It really worked out well for you, didn't it? What do you have in your life? Honestly, tell me.
I'm moving on.
Wilson is moving on.
And you? You've got nothing, House.
Nothing.
I'm going down there, and I'm gonna convince her to let me cut her leg off.
If you have any decency left, you'll stay out of it.
No.
Dr.
House promised.
If there was any other way It doesn't hurt right now.
I can wait.
Dr.
House, tell her.
Hanna, we have to amputate your leg.
No.
You said that there was time.
There was.
And it's run out.
No.
You asked me how I had hurt my leg.
I had a blood clot, and the muscle was dying.
And I had all these doctors telling me I should amputate.
And I said no.
And they did this very risky operation.
I almost died.
But you saved your leg.
I wish I hadn't.
They cut out a chunk of muscle about the size of my fist.
They left me with this mutilated, useless thing.
And I'm in pain every day.
And it changed me.
It made me a harder person.
A worse person.
And now Now I'm alone.
You don't wanna be like me.
You got a husband who loves you.
You have friends, you can start a family.
You have a life.
And this is just a leg.
Okay.
I got it.
I can't put you out 'cause it could depress your respiration too much.
This should take away some of the pain.
Will it be quick? I'll use the scalpel to slice through the skin, muscle and fat.
That should go pretty fast.
Then I'll switch over to the electric saw when I get to the bone.
It's two bones about as thick as a broom stick, and takes about as long to get through.
I'm gonna cut as close to the concrete as I can.
Save as much of your limb as possible.
Then the orthopedic surgeons back at the hospital will clean you up, have you fitted for a prosthetic.
You'll be running circles around me in no time.
How bad will it hurt? Like nothing you've ever felt before.
Hanna.
Baby, I'm so sorry.
Shut up.
It's all right.
You always loved my legs.
Baby, I don't care about your legs.
Baby, I love you.
I love you.
I love you.
What? He's fallen into a coma.
LP was clean, but What are his vitals? Excuse me, Officer.
What do you mean "Officer"? How long has there been a cop there? I don't know, He was being questioned when he fell into the coma.
Was anything else making him nervous or worried before his other symptoms? He was claustrophobic right before the bleed.
And before the fever, we told him that he probably did fall asleep.
It's his BP spiking.
But that didn't cause his first symptom.
Yeah, it did.
All the caffeine.
We thought the problem was in his toilet, and by that, of course, I mean his head, which distracted us from the fact that it could've been just a clog in his sewer pipe, and by that, of course, I mean his spinal cord and Blah, blah, blah, blah.
You get the idea.
An arachnoid cyst on his lower spine, that's why we missed it.
He's been sitting spiked his spinal fluid pressure.
Run a CT BP 72 over 42.
Hanna? Hanna? I can't breathe.
I can't breathe.
Breath sounds bilaterally.
It's not another pneumothorax.
Neck veins flat, no tamponade.
Damn it.
I waited too long.
Hanna, you've got a clot in your lungs.
I'm gonna fix this.
IV streptokinase.
What's happening? What's going on? Her body won't get any oxygen unless we can bust the clot.
This is a blood thinner.
Is she gonna be all right? It'll make her bleed more, we'll take care of that next.
It's not busting the clot.
Maybe it's the heart.
What? It's not a clot.
It's a fat embolism from the amputation.
Okay.
So what can we do? Come on.
Do something.
Please.
Please, do something.
Come on, guys, do something.
Come on.
Please, come on, do something.
Come on, do something! Do something! There's no way to prevent a fat embolism.
Even if you'd done this in an OR, you couldn't have saved her.
You can't blame yourself for her death.
This wasn't your fault.
That's the point! I did everything right.
She died anyway.
Why the hell did you think that would make me feel any better? You shouldn't be alone right now.
You're bleeding.
I'm gonna give you a task, as an employee.
Get out of my way.
What's that? I'm asking for some time off.
What's wrong? Are you okay? Obviously not.
You're gonna leap across the room and grab them out of my hand? No.
It's your choice if you wanna go back on drugs.
Okay.
Just so you know, I'm finding it hard to see the downside.
You need to rebandage your shoulder.
Is that why you're here? Foreman sent you? No.
Here to yell at me again? No.
Well, I'm running out of ideas.
Lucas Oh, great.
You're feeling uncomfortable again.
Probably means you just got back for some quickie wedding in Vegas, or you're already pregnant I ended it.
What? I'm stuck, House.
I keep wanting to move forward, I keep wanting to move on, and I can't.
I'm in my new house with my new fiancé, and all I can think about is you.
I just need to know if you and I can work.
You think I can fix myself? I don't know.
'Cause I am the most screwed up person in the world.
I know.
I love you.
I wish I didn't.
But I can't help it.
How do I know I'm not hallucinating? Did you take the Vicodin? Nope.
Then I think we're okay.
Yeah.

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