House, M.D. s01e14 Episode Script
HOU-114 - Control
Where are those projections? Three, six and nine are in their folders.
Can I have some more-- Excellent.
Tea's at your seat.
Hello.
Oh, hold on.
Ben Federman again, another pre-call.
We did the pre-call.
Is this the post pre-call call? The board's gonna want specifics with the push into the Asian markets.
Ben, there are no specifics about Asia.
We came up with that as a Hail Mary at 3:00 in the morning to placate the board about international.
Carly, I'm just giving you a heads-up about Asia.
There is no Asia.
Let's talk about Asia.
We're in the preliminary stages of forming a strategic alliance with Credit Lyonnais.
Within three months, you won't be able to walk four feet in Kangham, South Korea without seeing one of our beautiful models smiling at you from billboards and drugstore windows, inviting you in.
That's incredible news, Carly.
We'd hoped to hear something about Asia.
Had no idea plans were so far along.
Well, you know Asia.
Nothing's done until it's done.
Carly, I was wondering, could you walk us through what you were thinking for other Asian territories? Absolutely.
India has over half a billion women.
In terms of spending power, it's the single largest potential market in the world.
Um, we have retained a local firm to ensure that cultural differences are respected.
Um, however, I can't go into the specifics of my plan with you until tomorrow.
Right now I have a meeting and I need the room.
We were just getting started.
I know and I do apologize.
It's last minute, but the meeting is with three state department officials to smooth the way for China.
China? This is just incredible.
- We'll be in touch.
- Thank you.
What is it? I need a doctor.
I can't move my leg.
and severe pain in her right quad.
Go.
- How'd she get to you? - She's the C.
E.
O.
of Sonyo Cosmetics.
Three assistants and 15 V.
P.
's checked out who should be treating her.
Who da man? I da man.
I always suspected.
Dr.
House, I know the chances are very slim, but I'm sure you recognize that she may have what you had, a clot in her thigh.
A bit of a long shot.
- What about a disk herniation? - I don't know, Eric.
If her disk were herniated, she'd present with pain elsewhere, wouldn't she? - Yeah, I suppose.
- You're right.
A clot's also the most deadly, right, Robert? True.
The clot breaks off, she could stroke and die.
Dr.
House, I believe that they're right-- - Stop talking.
- What? You read one of those negotiating books, didn't you? Getting To Yes.
Fifty Ways to Win an Argument.
Hitchhiker's Guide to Being a Pal.
In five seconds, you just manipulated these two into agreeing with your point of view.
Fellas, this is known as soft positional bargaining.
It's not gonna work.
Dr.
House, are you saying that she doesn't have a clot, or are you saying that if she does have a clot, she doesn't need blood thinners and an angiogram? Chase, put her on blood thinners.
Do an angiogram.
When that comes back negative, M.
R.
I.
the spine.
If that's clean, cut her open and biopsy the leg.
Excellent suggestion.
Read less, more TV.
It's rare for an individual to make a donation significant enough to impact an organization as large and unwieldy as a hospital.
This donation does come with one string, that he be made chairman of the board.
I think that's a reasonable request.
I think he should have the right to know what it is we do with his $100 million.
Please welcome our new chairman of the board, Edward Vogler.
Thank you.
Thank you.
When I was 18, my dad loaned me $20,000 for a college tuition, which he would have known was a mistake had he known I wasn't actually in college.
I took his money and invested in a friend who had a little business.
And when my dad found out what I had done with his money, he and I didn't talk much after that.
But my friend's business took off, and I used the profits from that to buy another company and another.
And I must have been pretty good at it, had a good eye, because before I knew it, people were making offers for my company.
And about a year ago, I went public, and overnight I was worth a billion dollars.
So, I went to see my dad.
I'll admit.
I wanted a little payback.
You know, kind of shove the win in his face.
So, I drove upstate, and sat in the kitchen I grew up in, and, uh, he had no reaction.
It wasn't his fault.
He didn't even know who I was, because his Alzheimer's had taken a turn for the worse, despite the best drugs and care out there.
And that is why I'm here.
What if my contribution to this hospital is the difference between no cure and a cure for cancer? The difference between a man not recognizing his wife of 35 years and being able to look at her and say, "Good morning, honey.
I love you.
" If there's a disease out there killing people, I am writing you a blank check to fight back.
So, things are going to change a lot.
We're gonna have to ask you for the cell phone.
Do what you need to do.
I'm okay.
I'm pretty sure my X-ray machine can take your phone in a fight.
It'll fry it.
Fine.
- How old is she? - Thirty-two.
Wow.
And she's already the C.
E.
O.
of a public company.
She's a workaholic.
Okay, Carly, hold still.
The X-ray machine is gonna pass over your leg.
Okay.
What'd you do with your time off? Snowboarding in Gstaad.
Switzerland.
Do you ski or board? You can come with if you like.
Maybe we should start with a drink before we go around the world.
Oh, you wanna have a drink with me? Oh, very aggressive.
I like that.
I wanna run this place like a business.
What, you want to put more vending machines in the hallway? Maybe a roulette wheel? Nice one.
But I'm serious.
The product that you're selling is good health.
It shouldn't be a tough sell.
If you don't wanna sell, it means you don't care if people get your product.
You care if people are healthy, or are you too proud for that? Who's that? Oh, that's just one of our doctors.
Aren't, uh, doctors supposed to wear lab coats? - He's different.
- Everyone's buddy.
- No, not exactly.
- Then why does he get away with it? It's just a coat.
He's very good.
Hmm.
- Say "Ah".
- Ah.
Now really belt it out, like you're gonna throw up.
Ahh! Perfect.
Okay, that's it.
We should know in a couple of days what's growing in your son's throat.
Hello? - He can't talk.
- Excuse me? - He had knee surgery.
- Right? About a year ago, and then he couldn't talk.
Right.
Yeah, well, that happens.
You know, it's very dangerous operating so close to the vocal cords.
Okay.
Well, we'll send your kid's culture to the lab and somebody will call you.
Boo! Just wanted to see if your dad, you know-- Bizarre.
I need you to wear your lab coat.
I need two days of outrageous sex with someone obscenely younger than you, like half your age.
Wear the coat.
Man, oh, man, someone got spanked real good this morning.
A guy gives $100 million to cure cancer.
A pretty small concession to wear a lab coat.
Cure cancer? Is the hospital getting out of the dull business of treating patients? You know that's not what he's doing.
I know exactly what he's doing.
He's using us to run clinical trials.
Oh, shame on him, saving lives like that.
It's unethical.
Oh, are you coming in too? I thought I had you convinced.
Clinical trials save thousands of lives.
He's using patients as guinea pigs.
Pharmaceutical companies do that every day.
Are we a pharmaceutical company? We're gonna wind up pressuring desperate patients into choices that are bad for them, good for us.
We're gonna compromise patient care.
Who the hell am I talking to? Suddenly ethical lapses are a major concern for you? What's interesting is it suddenly doesn't bother you.
So, if you ignore ethics to save one person it's admirable, but if you do it to save a thousand, you're a bastard.
All he's done is taken your game and gone pro.
He's not gonna kill a few patients.
He's gonna kill this hospital.
It took him three seconds to size you up.
And surprise, he doesn't like you.
Wear the damn coat.
Hello.
I'm, uh, Dr.
Foreman.
I work with Dr.
House.
Our initial tests say you're fine.
We think you had a clot, but it resolved on its own.
So, we're gonna keep you overnight to be safe, and you can go back home tomorrow or back to work.
Hey, are you okay? Get in here! I need a line in her.
I.
V.
morphine, stat! You get any read on the new chairman of the board? - Yeah, he took your parking space.
- It's not necessarily bad news.
Do you ever watch Gilligan's Island reruns and really, really think they're gonna get off the island this time? We should introduce ourselves.
It couldn't hurt.
Make him a Bundt cake.
A patient hit a 10 on the pain scale.
What would explain that? There was no clot in her leg.
The angio was totally clean.
What about the muscle biopsy? No neurogenic or myopathic abnormalities.
She was also negative for trichinosis.
No toxoplasmosis or polyarteritis nodosa.
Robert, what was her sedimentation rate? Normal, Allison.
Therefore, no inflammation, no immunologic response.
Do you mind sharing that number with me? Fifteen, Allison.
- Are you mocking me? - Duh, Allison.
I'm just suggesting we look outside the box.
What if her sed rate is elevated? Well, let's go further outside the box.
Let's say the angio revealed a clot.
And then let's say we treated that clot, and now she's all better and personally thanked me by performing-- My Aunt Elyssa lives in Philadelphia.
Oh, it's story time.
Let me get my "baba".
Her normal temperature is 96.
2, not 98.
6 like you and me.
If her temperature were 98.
6, she'd have a fever.
I'm just wondering if you think we could apply the same logic to Carly's sed rate.
It's absurd.
I love it.
If 15 is high for Carly, then she has inflammation.
Which could, in turn, mean cancer.
I'll talk to Wilson.
Next time, skip Aunt Elyssa.
You're probably talking about a primary bone cancer.
It could be tricky to detect.
We'll need a bone scan.
That's why I'm talking to an oncologist.
Sure.
I've nothing better to do besides departmental meetings and budget reports.
New chairman of the board, you know.
Oh, I hadn't heard.
Right.
Clinical trials.
Completely unethical.
And a very bad omen for you.
There's not much money in curing African sleeping sickness.
No.
I have seen every scary movie ever made.
Six-year-old twins in front of an elevator of blood.
Boys' choirs.
Those are bad omens.
This is much more mundane.
A billionaire wants to get laid.
Billionaires buy movie studios to get laid.
They buy hospitals to get respect.
And the reason you want respect? To get laid.
Okay then.
Just gotta think like a billionaire.
Let's see.
There'll be big, scary changes and then, "Oh, Dr.
Cameron, we should have dinner to discuss your future on my G5 private jet.
" Come on.
You know how good you have it here.
Yes, I'm the big poobah, the big cheese, the go-to guy.
You do the cases you wanna do when you wanna do them.
You're not gonna have that anywhere else.
Relax.
I've been through three regime changes in this hospital.
Every time same story.
Just keep your head down.
That's all I'm saying.
And put on your coat.
It itches.
So, you gonna do this bone scan for me, or what? Yes.
Dr.
Simpson, did you hear? New management.
I'm thinking of switching to orthopedics.
How much do you guys get for a massage now? Without the happy ending.
Dr.
House, what do you want? Do you remember a guy named Van Der Meer? Not a big talker.
You fixed his A.
C.
L.
No, not according to my medical malpractice premiums.
Didn't get hypotensive during surgery? No strokes? Maybe some connectivity loss? What, you're gonna get involved now? I'm not involved.
A guy brought his son into the clinic.
I didn't touch the son.
I'm not taking any responsibility there.
The son's fine.
Can't shut him up.
Dad show any symptoms of cortical disease? Wernicke's? No.
Nothing.
That's why we settled because we couldn't find anything.
The guy got over a million dollars.
Don't tell me he's complaining.
He's not saying boo.
Your father wants to know when you'll be back from your trip.
E-mail back it's taking longer than I thought.
He doesn't need to see me like this.
What about your brother? - No.
- Hello.
I'm Dr.
Wilson.
I was-- - Um, Robin, I'm gonna need a minute.
- Oh.
Thank you.
There are two Dr.
Wilsons in this hospital, one in ophthalmology and one in cancer.
My eyes are fine, so I'm guessing you're here to tell me that I have cancer.
There is no cancer in your bone.
You're not smiling.
There's something called referred pain.
You could have cancer in one part of your body that presents in another.
Given your age and your family history, I'm thinking your colon.
Great.
I was at Columbia when my mom died.
Now there's a blast.
Cleaning up her vomit, and then running to my econ final.
Look.
If I'm a short-timer, give me drugs.
I'll go back to work.
I'll die there.
Whoa.
There's a very quick test to see if you even have it-- a colonoscopy.
I know how you do that test.
If you have colon cancer, we can treat it.
It's early.
That's what they told my mom.
She was dead six months later.
You're a smart person about to make a very bad decision.
You know, cancer treatment's come a long way in 12 years, but if you don't do this now-- I don't wanna be looked at.
There is another way.
We could do a virtual colonoscopy.
Basically, we do a C.
T.
scan of your colon.
It's noninvasive.
But it's very expensive.
I'm assuming that's not a problem.
Say yes.
Dr.
Becker-- Mr.
Van Der Meer.
What? Relax.
Ricky's gonna be just "finkf".
Strep throat.
Here's a prescription for an antibiotic.
He should be all better in a few days.
Although, this might sting a little.
I wanna see you again real soon.
Virtual colonoscopy was clean.
No colon cancer.
What happened to our regular, old-fashioned colonoscopy? She was uncomfortable doing any more tests.
I had to convince her to do that one.
Do you get that often? Women would rather die than get naked with you? She's scared.
But not of tests.
Just embarrassing ones.
Yeah.
It's not an inflammatory process.
It's not a clot, because Chase's angio says so.
And it's not cancer, because her tush is perfect.
Anybody else got an Aunt Elyssa with weird stuff? Maybe it's worth looking into-- I thought you said Carly's angio was clean.
It was clean.
You guys see the problem here? There's no indication of any abnormalities.
No lesions, no spurs, no mastis-- Her toes are screwed up.
They're backwards.
You guys know how much surgery it's gonna take to swap 'em back? What are you talking about? Well, either she literally has two left feet, or you angioed the wrong leg.
That's impossible.
It can't be-- Or maybe it was Jenny.
How come some resident signed this radiology report? Were you even in the room? - I'll redo her angio-- - You'll do nothing! Foreman, you do the angiogram.
I can't believe I did that.
Why do we have to redo the angiogram? There was a shadow on the first test result.
Shadow? A shadow means there could be a blood clot, right? I read Conn's Current Therapy.
A real page-turner.
No, it wasn't that kind of shadow.
My chest hurts.
It's from the tracer I injected.
You might also get a little nauseous or have a metallic taste.
All normal.
I'm a runner.
I shouldn't feel like this.
Carly, I'm looking at your vitals right now and-- I can't breathe.
Carly? My chest.
My chest.
Respiratory arrest.
Call code.
- What do you got? - She's drowning.
Foreman did a thoracentesis to drain the fluid from her lungs.
She's stable.
They sent the fluid to the lab.
It'll be back in a few hours.
You'll be happy to know Chase's mistake didn't cost her.
Angio revealed no clot.
I'm thrilled.
Okay, see, now you're just being stubborn.
It's cold.
It's a perfectly good excuse to wear your lab coat.
Carly needs a heart transplant.
Thoracentesis revealed a transudate? I haven't gotten it back yet.
Her MUGA scan, what was the ejection fraction? Maybe you could treat it surgically.
I haven't done the MUGA.
How do you know she needs a heart transplant? I got my aura read today.
It said someone close to me had a broken heart.
Since when do I need the secret pass code to talk to you? I can't tell you anything.
Professional responsibility.
Like that matters to you.
Not my professional responsibility, yours.
New regime.
You gotta keep your head down too.
Now that's good thinking, because I was gonna go right to Cuddy and rat you out as soon as you were done talking.
I'm not saying you want to.
I'm saying you'd be obligated to.
Because of my position on the board? Because of my position on the transplant committee? Hey, you brought this up for a reason.
You need to talk to me.
I can't.
You sure you're doing the right thing? I've come up with a few really great rationalizations.
Sorry to interrupt.
We have a problem.
Thoracentesis revealed a transudate.
We did an echo.
She's in severe congestive heart failure.
She needs a heart transplant.
- We'll get her on the list immediately.
- She's already on the list.
Come in.
Thanks.
What is a department of Diagnostic Medicine? That's Dr.
House's department.
They deal with cases that other doctors can't figure out.
It's a financial black hole.
The department costs us three million a year to treat one patient a week.
He saves one patient per week.
What about everyone else? His department's not going to find the cure for breast cancer.
- Uh, maybe not, but-- - Are you sleeping with House? What? No.
But you did.
Right? A long time ago? That's an incredibly inappropriate question.
If your judgment is compromised by a prior or current relationship, that is my business.
I respect him.
That is all you need to know.
He's still not wearing the coat.
Well, I told him-- I'm sure you did.
And yet he's not wearing it.
I'm just wondering if that's a reflection on him or on you.
You're Dr.
House.
I found a picture online of you at a conference.
You need a heart transplant.
- I run.
I work out-- - You cut yourself.
Probably highly ritualized.
You play the same Sarah McLachlan song over and over while you do it.
Probably works better than antidepressants.
- I don't understand how that-- - You're a high-powered bulimic.
You make yourself throw up.
You had to find the most efficient way to vomit without revealing the telltale signs of bulimia, which is all, ooh, very unseemly for a C.
E.
O.
So, you found a common antidote to accidental poisoning to do the job-- Ipecac.
Which is great if your kid's just swallowed a bottle of aspirin, but really, really bad if it's a habit.
It causes muscle damage.
It caused the pain in your leg.
And destroyed your heart.
How often do you do it? Three times a week.
In about an hour, there's gonna be an emergency meeting of the transplant committee to discuss where you fall on the list should a new heart become available.
Problem is, I am required to tell the committee about your bulimia.
It's a major psychiatric condition.
Ranks right up there with suicidal.
Makes you a very bad risk.
So, you're here to tell me I have just a few hours to live? Unless I lie to the committee.
But if they find out, I lose my medical license.
This would be a very good time to offer me a bribe.
You know, how much is your life worth? How much is my job worth? Why are you here doing this to me? What do you want? I wanna know what's right.
Am I worth it? You think I'm pathetic.
Has a goodjob.
Everything in the world.
But she just doesn't like the way that she looks.
Oh, stop hiding! I'm asking you if you wanna live or die? You can't even say that.
What do you want me to do? Cry? Yes.
I want you to tell me that your life is important to you, because I don't know.
Because that's what's on the table right now-- your life.
I don't wanna die.
I don't.
This 32-year-old female was admitted by my staff, because of paralysis and pain in her right thigh.
The patient rapidly deteriorated and now has severe congestive heart failure.
Pressors and vasodilators have not improved her condition whatsoever.
Pulmonary function tests show an F.
E.
C.
of over three liters, with F.
E.
V.
-1 of at least 90% of predicted and preserved F.
E.
D.
/F.
E.
C.
ratio and preserved D.
L.
C.
O.
as well.
Her MUGA had an ejection fraction of 19% with no focal wall motion abnormalities.
Heart catheterization revealed clean left, right and circumflex arteries.
And a subsequent biopsy revealed irreversible cardiomyopathy.
Which is why we're here.
Uh, Dr.
House, I'm confused by your time and date stamps.
It appears that you put Carly on the transplant list before you did these tests.
I had a hunch.
You don't have hunches.
You know.
Look, if the tests had come back differently, obviously I would have taken her off the list.
But on the long shot-- On the long shot that I was right, I didn't want to waste time.
Is there any exclusion criteria we should know about? CAT scan revealed no tumors, and Dr.
Wilson found no trace of cancer.
What about any other criteria? - No atherosclerotic vascular disease.
- Are there any-- No pneumonia, no bacteremia.
No hep "B" or "C" or any other letters.
Substance abuse.
Any history-- No alcohol.
No drugs.
Any psychiatric conditions? History of depression? She's a little blue.
But turns out she needs a heart transplant, so-- Dr.
House, if you subvert or mislead this committee, you will be subject to disciplinary action.
Dr.
Cuddy, do you have reason to think that I would lie? I simply want you to answer the question.
Is there anything on the recipient exclusion criteria that would disqualify your patient from getting a heart? No.
Beautiful organ donor weather.
You lied, didn't you? I never lie.
Big mistake.
Then you should have voted against putting her on the list.
- You're my friend.
- Oh, geez, have some backbone.
If you think I'm wrong, do something.
Wait.
You're getting mad at me for sticking up for you? You value our friendship more than your ethical responsibilities.
Our friendship is an ethical responsibility.
What is it? My patient's getting a heart.
He's not gonna fire you.
I'd fire you.
Bye-bye.
I screw up, the patient dies, I'll never get another job.
So stick your head between your legs and go lick your wounds in Gstaad.
Well, I like it here.
You guys don't think it's weird House knew the patient needed a heart transplant before we did any heart tests? That's House.
He knows things.
But usually he's putting it in our face.
Telling us how cleverly he figured it out.
This time nothing.
Just had a hunch.
That is weird.
Cauterize that one bleeder.
Okay, ready for the donor heart.
They just stopped Carly's heart, and your dumb patient-- They're all-- Oh, the guy who can't talk.
Mr.
Van Der Meer.
He's scheduled an appointment to see you.
Oh, goody.
I wanted you to know Chase is worried you're going to fire him.
It's bad enough that screwups cost lives.
Now we've got Vogler, screwups cost jobs.
I want Chase scared.
I want him doing everything he can to protect his job.
Dr.
House, if you were in his position, wouldn't you be more likely to perform well if you were reassured-- Oh, will you stop it with the book? Why are you doing this? I'm not doing anything.
You're manipulating everyone.
People dismiss me.
Because I'm a woman.
Because I'm pretty.
Because I'm not aggressive.
My opinions shouldn't be rejected just because people don't like me.
They like you.
Everyone likes you.
Do you? I have to know.
No.
Okay.
Five hours, 23 minutes.
That's fast.
Is that good or bad? It depends.
Either surgery went really well, or it ended really abruptly.
Textbook.
She'll outlive us all.
Thank you.
Triage nurse, pick up line 2741.
So, sing for me.
Oh, no, no, no, no.
Come on, look.
When you had your surgery, you were intubated.
The surgeon stuck a tube down your throat.
Now, it never happens and it's never caught, but it happened.
Your vocal cords were paralyzed.
I treated the spastic dysphonia with Botox.
Ironically, a substance that tightens every other corner of your face.
It actually loosens the tongue.
I have healed you.
You can talk.
Oh, well.
Boo! Okay.
You don't have to say anything.
It can be our little secret.
If you can talk, blink twice.
But you're not going to, because you think you won't be entitled to the money you won in the settlement with Simpson.
Yesterday, I would have said you had to give the money back.
Today, hospital's come into a lot of money.
Mum's the word.
Hey.
Hey.
I know the cardiologist has given you some guidelines, a schedule of medication and a strict diet.
Just what somebody with an eating disorder needs.
So I thought I'd get you started.
Fried chicken from the Carnegie Deli.
- You're kidding.
- Yeah.
Actually, I got it downstairs.
Why did you fight for me? You risked so much, and you hardly know me.
You're my patient.
Don't screw it up.
Love this part! Okay.
He ruined it.
Just wanted to stop by and introduce myself.
I'm Edward Vogler, new chairman of the board.
In a way, I guess that makes me your boss.
I am sorry about the lab coat thing.
My dry cleaners just destroyed it.
That was my very first heart transplant committee meeting.
Very exciting.
Trust me, Six Flags-- way more exciting.
Your patient's very lucky to have such a passionate doctor.
Stands up for what he believes in.
Sweet of you to say.
Yeah.
Afraid you've been duped though.
The nurse found this in the patient's purse.
Oh, my.
If only I'd known.
Tough being a doctor, having all that power.
The power to play God.
Yes.
I don't envy the transplant committee their responsibility.
They basically would have been forced to kill that poor girl.
I'm not sure I could have done that.
This is not a game to me, Dr.
House.
No.
It's actually more like we're dancing right now.
So let's get to the point.
You don't like me.
I'm pretty sure I'm not gonna like you.
It's nothing personal.
I don't like anybody.
But none of that really matters, does it? Because you've got money, and I've got tenure.
You need full board approval to get rid of me.
I've got Cuddy.
Right.
And Wilson.
So, as long as we're stuck with each other, we might as well ignore each other.
That wasn't nearly as dramatic as I was hoping.
I looked into that tenure thing, and you're right.
It's actually easier for me to get rid of a board member like Cuddy or Wilson than to get rid of a doctor.
That's interesting, isn't it?
Can I have some more-- Excellent.
Tea's at your seat.
Hello.
Oh, hold on.
Ben Federman again, another pre-call.
We did the pre-call.
Is this the post pre-call call? The board's gonna want specifics with the push into the Asian markets.
Ben, there are no specifics about Asia.
We came up with that as a Hail Mary at 3:00 in the morning to placate the board about international.
Carly, I'm just giving you a heads-up about Asia.
There is no Asia.
Let's talk about Asia.
We're in the preliminary stages of forming a strategic alliance with Credit Lyonnais.
Within three months, you won't be able to walk four feet in Kangham, South Korea without seeing one of our beautiful models smiling at you from billboards and drugstore windows, inviting you in.
That's incredible news, Carly.
We'd hoped to hear something about Asia.
Had no idea plans were so far along.
Well, you know Asia.
Nothing's done until it's done.
Carly, I was wondering, could you walk us through what you were thinking for other Asian territories? Absolutely.
India has over half a billion women.
In terms of spending power, it's the single largest potential market in the world.
Um, we have retained a local firm to ensure that cultural differences are respected.
Um, however, I can't go into the specifics of my plan with you until tomorrow.
Right now I have a meeting and I need the room.
We were just getting started.
I know and I do apologize.
It's last minute, but the meeting is with three state department officials to smooth the way for China.
China? This is just incredible.
- We'll be in touch.
- Thank you.
What is it? I need a doctor.
I can't move my leg.
and severe pain in her right quad.
Go.
- How'd she get to you? - She's the C.
E.
O.
of Sonyo Cosmetics.
Three assistants and 15 V.
P.
's checked out who should be treating her.
Who da man? I da man.
I always suspected.
Dr.
House, I know the chances are very slim, but I'm sure you recognize that she may have what you had, a clot in her thigh.
A bit of a long shot.
- What about a disk herniation? - I don't know, Eric.
If her disk were herniated, she'd present with pain elsewhere, wouldn't she? - Yeah, I suppose.
- You're right.
A clot's also the most deadly, right, Robert? True.
The clot breaks off, she could stroke and die.
Dr.
House, I believe that they're right-- - Stop talking.
- What? You read one of those negotiating books, didn't you? Getting To Yes.
Fifty Ways to Win an Argument.
Hitchhiker's Guide to Being a Pal.
In five seconds, you just manipulated these two into agreeing with your point of view.
Fellas, this is known as soft positional bargaining.
It's not gonna work.
Dr.
House, are you saying that she doesn't have a clot, or are you saying that if she does have a clot, she doesn't need blood thinners and an angiogram? Chase, put her on blood thinners.
Do an angiogram.
When that comes back negative, M.
R.
I.
the spine.
If that's clean, cut her open and biopsy the leg.
Excellent suggestion.
Read less, more TV.
It's rare for an individual to make a donation significant enough to impact an organization as large and unwieldy as a hospital.
This donation does come with one string, that he be made chairman of the board.
I think that's a reasonable request.
I think he should have the right to know what it is we do with his $100 million.
Please welcome our new chairman of the board, Edward Vogler.
Thank you.
Thank you.
When I was 18, my dad loaned me $20,000 for a college tuition, which he would have known was a mistake had he known I wasn't actually in college.
I took his money and invested in a friend who had a little business.
And when my dad found out what I had done with his money, he and I didn't talk much after that.
But my friend's business took off, and I used the profits from that to buy another company and another.
And I must have been pretty good at it, had a good eye, because before I knew it, people were making offers for my company.
And about a year ago, I went public, and overnight I was worth a billion dollars.
So, I went to see my dad.
I'll admit.
I wanted a little payback.
You know, kind of shove the win in his face.
So, I drove upstate, and sat in the kitchen I grew up in, and, uh, he had no reaction.
It wasn't his fault.
He didn't even know who I was, because his Alzheimer's had taken a turn for the worse, despite the best drugs and care out there.
And that is why I'm here.
What if my contribution to this hospital is the difference between no cure and a cure for cancer? The difference between a man not recognizing his wife of 35 years and being able to look at her and say, "Good morning, honey.
I love you.
" If there's a disease out there killing people, I am writing you a blank check to fight back.
So, things are going to change a lot.
We're gonna have to ask you for the cell phone.
Do what you need to do.
I'm okay.
I'm pretty sure my X-ray machine can take your phone in a fight.
It'll fry it.
Fine.
- How old is she? - Thirty-two.
Wow.
And she's already the C.
E.
O.
of a public company.
She's a workaholic.
Okay, Carly, hold still.
The X-ray machine is gonna pass over your leg.
Okay.
What'd you do with your time off? Snowboarding in Gstaad.
Switzerland.
Do you ski or board? You can come with if you like.
Maybe we should start with a drink before we go around the world.
Oh, you wanna have a drink with me? Oh, very aggressive.
I like that.
I wanna run this place like a business.
What, you want to put more vending machines in the hallway? Maybe a roulette wheel? Nice one.
But I'm serious.
The product that you're selling is good health.
It shouldn't be a tough sell.
If you don't wanna sell, it means you don't care if people get your product.
You care if people are healthy, or are you too proud for that? Who's that? Oh, that's just one of our doctors.
Aren't, uh, doctors supposed to wear lab coats? - He's different.
- Everyone's buddy.
- No, not exactly.
- Then why does he get away with it? It's just a coat.
He's very good.
Hmm.
- Say "Ah".
- Ah.
Now really belt it out, like you're gonna throw up.
Ahh! Perfect.
Okay, that's it.
We should know in a couple of days what's growing in your son's throat.
Hello? - He can't talk.
- Excuse me? - He had knee surgery.
- Right? About a year ago, and then he couldn't talk.
Right.
Yeah, well, that happens.
You know, it's very dangerous operating so close to the vocal cords.
Okay.
Well, we'll send your kid's culture to the lab and somebody will call you.
Boo! Just wanted to see if your dad, you know-- Bizarre.
I need you to wear your lab coat.
I need two days of outrageous sex with someone obscenely younger than you, like half your age.
Wear the coat.
Man, oh, man, someone got spanked real good this morning.
A guy gives $100 million to cure cancer.
A pretty small concession to wear a lab coat.
Cure cancer? Is the hospital getting out of the dull business of treating patients? You know that's not what he's doing.
I know exactly what he's doing.
He's using us to run clinical trials.
Oh, shame on him, saving lives like that.
It's unethical.
Oh, are you coming in too? I thought I had you convinced.
Clinical trials save thousands of lives.
He's using patients as guinea pigs.
Pharmaceutical companies do that every day.
Are we a pharmaceutical company? We're gonna wind up pressuring desperate patients into choices that are bad for them, good for us.
We're gonna compromise patient care.
Who the hell am I talking to? Suddenly ethical lapses are a major concern for you? What's interesting is it suddenly doesn't bother you.
So, if you ignore ethics to save one person it's admirable, but if you do it to save a thousand, you're a bastard.
All he's done is taken your game and gone pro.
He's not gonna kill a few patients.
He's gonna kill this hospital.
It took him three seconds to size you up.
And surprise, he doesn't like you.
Wear the damn coat.
Hello.
I'm, uh, Dr.
Foreman.
I work with Dr.
House.
Our initial tests say you're fine.
We think you had a clot, but it resolved on its own.
So, we're gonna keep you overnight to be safe, and you can go back home tomorrow or back to work.
Hey, are you okay? Get in here! I need a line in her.
I.
V.
morphine, stat! You get any read on the new chairman of the board? - Yeah, he took your parking space.
- It's not necessarily bad news.
Do you ever watch Gilligan's Island reruns and really, really think they're gonna get off the island this time? We should introduce ourselves.
It couldn't hurt.
Make him a Bundt cake.
A patient hit a 10 on the pain scale.
What would explain that? There was no clot in her leg.
The angio was totally clean.
What about the muscle biopsy? No neurogenic or myopathic abnormalities.
She was also negative for trichinosis.
No toxoplasmosis or polyarteritis nodosa.
Robert, what was her sedimentation rate? Normal, Allison.
Therefore, no inflammation, no immunologic response.
Do you mind sharing that number with me? Fifteen, Allison.
- Are you mocking me? - Duh, Allison.
I'm just suggesting we look outside the box.
What if her sed rate is elevated? Well, let's go further outside the box.
Let's say the angio revealed a clot.
And then let's say we treated that clot, and now she's all better and personally thanked me by performing-- My Aunt Elyssa lives in Philadelphia.
Oh, it's story time.
Let me get my "baba".
Her normal temperature is 96.
2, not 98.
6 like you and me.
If her temperature were 98.
6, she'd have a fever.
I'm just wondering if you think we could apply the same logic to Carly's sed rate.
It's absurd.
I love it.
If 15 is high for Carly, then she has inflammation.
Which could, in turn, mean cancer.
I'll talk to Wilson.
Next time, skip Aunt Elyssa.
You're probably talking about a primary bone cancer.
It could be tricky to detect.
We'll need a bone scan.
That's why I'm talking to an oncologist.
Sure.
I've nothing better to do besides departmental meetings and budget reports.
New chairman of the board, you know.
Oh, I hadn't heard.
Right.
Clinical trials.
Completely unethical.
And a very bad omen for you.
There's not much money in curing African sleeping sickness.
No.
I have seen every scary movie ever made.
Six-year-old twins in front of an elevator of blood.
Boys' choirs.
Those are bad omens.
This is much more mundane.
A billionaire wants to get laid.
Billionaires buy movie studios to get laid.
They buy hospitals to get respect.
And the reason you want respect? To get laid.
Okay then.
Just gotta think like a billionaire.
Let's see.
There'll be big, scary changes and then, "Oh, Dr.
Cameron, we should have dinner to discuss your future on my G5 private jet.
" Come on.
You know how good you have it here.
Yes, I'm the big poobah, the big cheese, the go-to guy.
You do the cases you wanna do when you wanna do them.
You're not gonna have that anywhere else.
Relax.
I've been through three regime changes in this hospital.
Every time same story.
Just keep your head down.
That's all I'm saying.
And put on your coat.
It itches.
So, you gonna do this bone scan for me, or what? Yes.
Dr.
Simpson, did you hear? New management.
I'm thinking of switching to orthopedics.
How much do you guys get for a massage now? Without the happy ending.
Dr.
House, what do you want? Do you remember a guy named Van Der Meer? Not a big talker.
You fixed his A.
C.
L.
No, not according to my medical malpractice premiums.
Didn't get hypotensive during surgery? No strokes? Maybe some connectivity loss? What, you're gonna get involved now? I'm not involved.
A guy brought his son into the clinic.
I didn't touch the son.
I'm not taking any responsibility there.
The son's fine.
Can't shut him up.
Dad show any symptoms of cortical disease? Wernicke's? No.
Nothing.
That's why we settled because we couldn't find anything.
The guy got over a million dollars.
Don't tell me he's complaining.
He's not saying boo.
Your father wants to know when you'll be back from your trip.
E-mail back it's taking longer than I thought.
He doesn't need to see me like this.
What about your brother? - No.
- Hello.
I'm Dr.
Wilson.
I was-- - Um, Robin, I'm gonna need a minute.
- Oh.
Thank you.
There are two Dr.
Wilsons in this hospital, one in ophthalmology and one in cancer.
My eyes are fine, so I'm guessing you're here to tell me that I have cancer.
There is no cancer in your bone.
You're not smiling.
There's something called referred pain.
You could have cancer in one part of your body that presents in another.
Given your age and your family history, I'm thinking your colon.
Great.
I was at Columbia when my mom died.
Now there's a blast.
Cleaning up her vomit, and then running to my econ final.
Look.
If I'm a short-timer, give me drugs.
I'll go back to work.
I'll die there.
Whoa.
There's a very quick test to see if you even have it-- a colonoscopy.
I know how you do that test.
If you have colon cancer, we can treat it.
It's early.
That's what they told my mom.
She was dead six months later.
You're a smart person about to make a very bad decision.
You know, cancer treatment's come a long way in 12 years, but if you don't do this now-- I don't wanna be looked at.
There is another way.
We could do a virtual colonoscopy.
Basically, we do a C.
T.
scan of your colon.
It's noninvasive.
But it's very expensive.
I'm assuming that's not a problem.
Say yes.
Dr.
Becker-- Mr.
Van Der Meer.
What? Relax.
Ricky's gonna be just "finkf".
Strep throat.
Here's a prescription for an antibiotic.
He should be all better in a few days.
Although, this might sting a little.
I wanna see you again real soon.
Virtual colonoscopy was clean.
No colon cancer.
What happened to our regular, old-fashioned colonoscopy? She was uncomfortable doing any more tests.
I had to convince her to do that one.
Do you get that often? Women would rather die than get naked with you? She's scared.
But not of tests.
Just embarrassing ones.
Yeah.
It's not an inflammatory process.
It's not a clot, because Chase's angio says so.
And it's not cancer, because her tush is perfect.
Anybody else got an Aunt Elyssa with weird stuff? Maybe it's worth looking into-- I thought you said Carly's angio was clean.
It was clean.
You guys see the problem here? There's no indication of any abnormalities.
No lesions, no spurs, no mastis-- Her toes are screwed up.
They're backwards.
You guys know how much surgery it's gonna take to swap 'em back? What are you talking about? Well, either she literally has two left feet, or you angioed the wrong leg.
That's impossible.
It can't be-- Or maybe it was Jenny.
How come some resident signed this radiology report? Were you even in the room? - I'll redo her angio-- - You'll do nothing! Foreman, you do the angiogram.
I can't believe I did that.
Why do we have to redo the angiogram? There was a shadow on the first test result.
Shadow? A shadow means there could be a blood clot, right? I read Conn's Current Therapy.
A real page-turner.
No, it wasn't that kind of shadow.
My chest hurts.
It's from the tracer I injected.
You might also get a little nauseous or have a metallic taste.
All normal.
I'm a runner.
I shouldn't feel like this.
Carly, I'm looking at your vitals right now and-- I can't breathe.
Carly? My chest.
My chest.
Respiratory arrest.
Call code.
- What do you got? - She's drowning.
Foreman did a thoracentesis to drain the fluid from her lungs.
She's stable.
They sent the fluid to the lab.
It'll be back in a few hours.
You'll be happy to know Chase's mistake didn't cost her.
Angio revealed no clot.
I'm thrilled.
Okay, see, now you're just being stubborn.
It's cold.
It's a perfectly good excuse to wear your lab coat.
Carly needs a heart transplant.
Thoracentesis revealed a transudate? I haven't gotten it back yet.
Her MUGA scan, what was the ejection fraction? Maybe you could treat it surgically.
I haven't done the MUGA.
How do you know she needs a heart transplant? I got my aura read today.
It said someone close to me had a broken heart.
Since when do I need the secret pass code to talk to you? I can't tell you anything.
Professional responsibility.
Like that matters to you.
Not my professional responsibility, yours.
New regime.
You gotta keep your head down too.
Now that's good thinking, because I was gonna go right to Cuddy and rat you out as soon as you were done talking.
I'm not saying you want to.
I'm saying you'd be obligated to.
Because of my position on the board? Because of my position on the transplant committee? Hey, you brought this up for a reason.
You need to talk to me.
I can't.
You sure you're doing the right thing? I've come up with a few really great rationalizations.
Sorry to interrupt.
We have a problem.
Thoracentesis revealed a transudate.
We did an echo.
She's in severe congestive heart failure.
She needs a heart transplant.
- We'll get her on the list immediately.
- She's already on the list.
Come in.
Thanks.
What is a department of Diagnostic Medicine? That's Dr.
House's department.
They deal with cases that other doctors can't figure out.
It's a financial black hole.
The department costs us three million a year to treat one patient a week.
He saves one patient per week.
What about everyone else? His department's not going to find the cure for breast cancer.
- Uh, maybe not, but-- - Are you sleeping with House? What? No.
But you did.
Right? A long time ago? That's an incredibly inappropriate question.
If your judgment is compromised by a prior or current relationship, that is my business.
I respect him.
That is all you need to know.
He's still not wearing the coat.
Well, I told him-- I'm sure you did.
And yet he's not wearing it.
I'm just wondering if that's a reflection on him or on you.
You're Dr.
House.
I found a picture online of you at a conference.
You need a heart transplant.
- I run.
I work out-- - You cut yourself.
Probably highly ritualized.
You play the same Sarah McLachlan song over and over while you do it.
Probably works better than antidepressants.
- I don't understand how that-- - You're a high-powered bulimic.
You make yourself throw up.
You had to find the most efficient way to vomit without revealing the telltale signs of bulimia, which is all, ooh, very unseemly for a C.
E.
O.
So, you found a common antidote to accidental poisoning to do the job-- Ipecac.
Which is great if your kid's just swallowed a bottle of aspirin, but really, really bad if it's a habit.
It causes muscle damage.
It caused the pain in your leg.
And destroyed your heart.
How often do you do it? Three times a week.
In about an hour, there's gonna be an emergency meeting of the transplant committee to discuss where you fall on the list should a new heart become available.
Problem is, I am required to tell the committee about your bulimia.
It's a major psychiatric condition.
Ranks right up there with suicidal.
Makes you a very bad risk.
So, you're here to tell me I have just a few hours to live? Unless I lie to the committee.
But if they find out, I lose my medical license.
This would be a very good time to offer me a bribe.
You know, how much is your life worth? How much is my job worth? Why are you here doing this to me? What do you want? I wanna know what's right.
Am I worth it? You think I'm pathetic.
Has a goodjob.
Everything in the world.
But she just doesn't like the way that she looks.
Oh, stop hiding! I'm asking you if you wanna live or die? You can't even say that.
What do you want me to do? Cry? Yes.
I want you to tell me that your life is important to you, because I don't know.
Because that's what's on the table right now-- your life.
I don't wanna die.
I don't.
This 32-year-old female was admitted by my staff, because of paralysis and pain in her right thigh.
The patient rapidly deteriorated and now has severe congestive heart failure.
Pressors and vasodilators have not improved her condition whatsoever.
Pulmonary function tests show an F.
E.
C.
of over three liters, with F.
E.
V.
-1 of at least 90% of predicted and preserved F.
E.
D.
/F.
E.
C.
ratio and preserved D.
L.
C.
O.
as well.
Her MUGA had an ejection fraction of 19% with no focal wall motion abnormalities.
Heart catheterization revealed clean left, right and circumflex arteries.
And a subsequent biopsy revealed irreversible cardiomyopathy.
Which is why we're here.
Uh, Dr.
House, I'm confused by your time and date stamps.
It appears that you put Carly on the transplant list before you did these tests.
I had a hunch.
You don't have hunches.
You know.
Look, if the tests had come back differently, obviously I would have taken her off the list.
But on the long shot-- On the long shot that I was right, I didn't want to waste time.
Is there any exclusion criteria we should know about? CAT scan revealed no tumors, and Dr.
Wilson found no trace of cancer.
What about any other criteria? - No atherosclerotic vascular disease.
- Are there any-- No pneumonia, no bacteremia.
No hep "B" or "C" or any other letters.
Substance abuse.
Any history-- No alcohol.
No drugs.
Any psychiatric conditions? History of depression? She's a little blue.
But turns out she needs a heart transplant, so-- Dr.
House, if you subvert or mislead this committee, you will be subject to disciplinary action.
Dr.
Cuddy, do you have reason to think that I would lie? I simply want you to answer the question.
Is there anything on the recipient exclusion criteria that would disqualify your patient from getting a heart? No.
Beautiful organ donor weather.
You lied, didn't you? I never lie.
Big mistake.
Then you should have voted against putting her on the list.
- You're my friend.
- Oh, geez, have some backbone.
If you think I'm wrong, do something.
Wait.
You're getting mad at me for sticking up for you? You value our friendship more than your ethical responsibilities.
Our friendship is an ethical responsibility.
What is it? My patient's getting a heart.
He's not gonna fire you.
I'd fire you.
Bye-bye.
I screw up, the patient dies, I'll never get another job.
So stick your head between your legs and go lick your wounds in Gstaad.
Well, I like it here.
You guys don't think it's weird House knew the patient needed a heart transplant before we did any heart tests? That's House.
He knows things.
But usually he's putting it in our face.
Telling us how cleverly he figured it out.
This time nothing.
Just had a hunch.
That is weird.
Cauterize that one bleeder.
Okay, ready for the donor heart.
They just stopped Carly's heart, and your dumb patient-- They're all-- Oh, the guy who can't talk.
Mr.
Van Der Meer.
He's scheduled an appointment to see you.
Oh, goody.
I wanted you to know Chase is worried you're going to fire him.
It's bad enough that screwups cost lives.
Now we've got Vogler, screwups cost jobs.
I want Chase scared.
I want him doing everything he can to protect his job.
Dr.
House, if you were in his position, wouldn't you be more likely to perform well if you were reassured-- Oh, will you stop it with the book? Why are you doing this? I'm not doing anything.
You're manipulating everyone.
People dismiss me.
Because I'm a woman.
Because I'm pretty.
Because I'm not aggressive.
My opinions shouldn't be rejected just because people don't like me.
They like you.
Everyone likes you.
Do you? I have to know.
No.
Okay.
Five hours, 23 minutes.
That's fast.
Is that good or bad? It depends.
Either surgery went really well, or it ended really abruptly.
Textbook.
She'll outlive us all.
Thank you.
Triage nurse, pick up line 2741.
So, sing for me.
Oh, no, no, no, no.
Come on, look.
When you had your surgery, you were intubated.
The surgeon stuck a tube down your throat.
Now, it never happens and it's never caught, but it happened.
Your vocal cords were paralyzed.
I treated the spastic dysphonia with Botox.
Ironically, a substance that tightens every other corner of your face.
It actually loosens the tongue.
I have healed you.
You can talk.
Oh, well.
Boo! Okay.
You don't have to say anything.
It can be our little secret.
If you can talk, blink twice.
But you're not going to, because you think you won't be entitled to the money you won in the settlement with Simpson.
Yesterday, I would have said you had to give the money back.
Today, hospital's come into a lot of money.
Mum's the word.
Hey.
Hey.
I know the cardiologist has given you some guidelines, a schedule of medication and a strict diet.
Just what somebody with an eating disorder needs.
So I thought I'd get you started.
Fried chicken from the Carnegie Deli.
- You're kidding.
- Yeah.
Actually, I got it downstairs.
Why did you fight for me? You risked so much, and you hardly know me.
You're my patient.
Don't screw it up.
Love this part! Okay.
He ruined it.
Just wanted to stop by and introduce myself.
I'm Edward Vogler, new chairman of the board.
In a way, I guess that makes me your boss.
I am sorry about the lab coat thing.
My dry cleaners just destroyed it.
That was my very first heart transplant committee meeting.
Very exciting.
Trust me, Six Flags-- way more exciting.
Your patient's very lucky to have such a passionate doctor.
Stands up for what he believes in.
Sweet of you to say.
Yeah.
Afraid you've been duped though.
The nurse found this in the patient's purse.
Oh, my.
If only I'd known.
Tough being a doctor, having all that power.
The power to play God.
Yes.
I don't envy the transplant committee their responsibility.
They basically would have been forced to kill that poor girl.
I'm not sure I could have done that.
This is not a game to me, Dr.
House.
No.
It's actually more like we're dancing right now.
So let's get to the point.
You don't like me.
I'm pretty sure I'm not gonna like you.
It's nothing personal.
I don't like anybody.
But none of that really matters, does it? Because you've got money, and I've got tenure.
You need full board approval to get rid of me.
I've got Cuddy.
Right.
And Wilson.
So, as long as we're stuck with each other, we might as well ignore each other.
That wasn't nearly as dramatic as I was hoping.
I looked into that tenure thing, and you're right.
It's actually easier for me to get rid of a board member like Cuddy or Wilson than to get rid of a doctor.
That's interesting, isn't it?