House, M.D. s02e19 Episode Script

My offer's withdrawn.
You can walk to work.
Got it.
You're morally outraged.
Now, can we get through this part? 'Cause the next part's awesome.
How do you rationalize something like this? You broke into Stacy's therapist's office.
Borrowed a key.
And stole her treatment notes.
Nope.
I made copies.
"Mark is," and I quote " withdrawn, passive aggressive, won't communicate, "like he resents me because I can walk.
" I don't wanna hear this.
"Dishes in the sink, toilet seat up.
" Meanwhile, she can't stop thinking about I can't read that, is she obsessed with a gray horse or me? It says she thinks you're an annoying jerk.
It's a pet name.
Here's the kicker.
They're not having sex? Doctor cleared him, but no lift-off.
She's frustrated, so she's doc-blocking me.
Paperwork, seminars, meddling with my patients.
But now you've got the proof you need, just take those personal psych records to Cuddy, and that'll show her Stacy's out of control.
You ignoring me? While looking for my newspaper.
Efficient, huh? Over here.
Dr.
Wilson, I want you to meet my stalker.
Your waiting room sucks.
I am not treating you.
Because you're a closet case? We're not together.
He is so self-loathing.
But we gotta go now.
So, maybe see you after work.
No, no, no, no.
Nobody can figure out what's wrong with me.
Well, your shirt is gaping at the collar.
That means you've lost weight.
You're flushed, that's fever, and you're short of breath.
And finally, there's the KS lesion on your face.
It means you're HIV positive, and you've progressed to full-blown AIDS.
So you're sick because your immune system is shot and someone sneezed on you.
May I be excused now? Brilliant, but my immune system is fine.
Your concentration-camp physique begs to differ.
Get your T-cell count re-checked.
I've already done that.
They test for T- cell lymphoma? It was negative.
All of this will be fascinating to an HIV specialist.
Now let go of my cane before it becomes your new boyfriend.
Honey, I will marry it if you will look at my file.
Congress says you can't, so I didn't touch him.
He's going into anaphylactic shock.
Go see Stacy.
We gave him epi.
He's fine.
You need a lawyer.
Go see Stacy.
You hit a patient.
Four words, two mistakes.
He's not a patient, and I didn't hit him.
Of course you didn't.
Go see Stacy.
I didn't cause the anaphylaxis.
It's probably one of his HIV meds.
Abacavir.
I'll pass that along, make sure the ER takes him off it.
Go see Stacy.
You have to treat him.
Medically, this case is a snooze-fest.
AIDS plus infection.
You don't treat him, he charges you with assault.
Just 'cause he says I hit him, doesn't make it true.
Watch, I am surrounded by naked cheerleaders.
See? Although, I like my chances of some action this morning.
I forgot Wednesday was hooker day.
This could have waited.
You make me meet you at your house.
Your husband is conveniently absent.
Mark's at physio.
I'm stuck waiting for the exterminator.
I saw a rat last night.
Well, I'm surprised your feet are touching the floor.
I barely slept.
What was Mark up to? If memory serves, a quick climb up Mount Gregory, and you'd doze through a seal hunt.
Clubbing, shrieking.
What're you doing? Sorry, it was just driving me nuts.
You hate washing dishes.
People change.
I could make sure you'd sleep like a baby tonight.
Rather take care of it myself.
I was referring to the rat.
Trenton Pest is sending a guy.
What's going on? It's not what you think.
I know it looks like we're cleaning dishes, but actually we're having sex.
We're working.
Wow, wish I had become a doctor.
Place would be spotless.
Take 10 minutes, cure the guy, and stop whining.
I give you Kalvin Ryan, so flamboyant in person, so boring on paper.
Obviously got an opportunistic infection, probably TB or PCP.
Have you read his file? I started, but I found the characters two-dimensional.
He went to an HIV clinic last week.
Tested negative for TB, PCP, MAC, CMV, HSV.
It's not an infection.
HIV clinic.
So few patients, so much money.
Redo the tests.
The results make sense.
Kalvin's T-cells are at 200.
That's strong enough to fight infection.
Fine, parasite.
Nope.
The stool sample was negative.
Two months ago, he was down to 30 T-cells.
Then he changed his meds, his immune system rebounds, his viral load drops, everything's getting better, but he's getting sicker.
Face it.
This might be an interesting case.
What if his immune system is too strong? An auto-immune disease? With HIV, that's impossible.
His new HIV meds kicked his system out of a sound sleep.
It wakes up hungry, cranky, spoiling for a fight.
And when it doesn't find an active infection, it starts attacking the harmless remnants of old infections.
Immune reconstitution syndrome.
His meds made him so much better, he made himself sick? Sounds pretty Boring! This is so not interesting.
Chest x-ray to find the old infection and start him on steroids.
If you're wrong, the steroids will tank his immune system.
He'll get worse.
Now that would be interesting.
Where's the Coumadin? If your patient's got a blood problem, then blood thinners aren't exactly It's for Stacy's rat.
Death by anticoagulation.
Trying to win Stacy back by killing an animal.
Very caveman.
I don't want her back.
I just want her to admit her feelings for me.
I go to Cuddy, Cuddy fires her or reassigns her.
Either way, I'm happy.
If you want her back, either tell her or, better yet, shut up and cry yourself to sleep like everybody else.
Hi, this is, Mark Warner, Listen, you don't need to send that guy down.
We caught him.
No, you should send the bill to Princeton-Plainsboro Hospital, attention Dr.
James Wilson.
Yeah.
Your lymph nodes aren't swollen, that's good.
Maybe Dr.
Chase should check.
Sorry, mate, hands full.
He's too pretty to be straight.
You ever done any modeling? Does anyone actually fall for that line? Every day.
Why do you think I became a photographer? I'm guessing you guys didn't think about dating on career day.
I love my job.
Really? You seem more the "find it exceptionally satisfying" type.
I'm not sure there's a difference.
Your mom died of diabetes.
How's your dad's health? Last I heard, he had cirrhosis.
Love is love.
Satisfying is "social validation, fun can wait.
" I have fun.
Yeah, she's got some scheduled for February.
Last you heard, your father? He threw me out when I was 16.
It's just as well.
I got tired of getting BB guns for my birthday when I'd asked for a Barbie.
Dads can be real sweethearts.
Sensitive and cute.
He's cute.
He ran into that heating vent, right there.
Hopefully, Mark's anger will go away eventually.
He's not angry, he just doesn't like you.
Nothing unique there.
Didn't seem real wild about you, either.
He's fine with me.
He's angry.
Said so in group.
Of course he's angry.
He's looking at months of painful physio.
He's mad at you.
There's no way he said that.
No.
But it's true.
He resents you for being able to walk.
Been there.
I resented you for a hell of a long time.
Past tense? Might be the hospital.
What? Bad time? Where are you? At your girlfriend's place.
Ignore the moaning and squeaking.
His lungs are too scarred to tell which infection triggered the immune reconstitution.
He a smoker? Yes, and possibly more than cigarettes.
His tox screen came back positive for recreational drugs.
Not surprising, not medically relevant.
His heart looks a little enlarged.
That's a typical side effect of AZT.
What are Kalvin's most recent infections? Toxo, CMV, and PCP.
Well, let's assume it's one of those.
Give him ganciclovir for the CMV.
We can hardly hear you.
Where are you? In a closet.
Your girlfriend's other boyfriend showed up.
Ganciclovir for the CMV.
Sulfadiazine for the toxo, Bactrim for PCP.
Gotta go.
It's killing time.
Your tox screen came back positive for Crystal meth and ecstasy.
Recreational drugs are dangerous to begin with, but for someone with HIV I didn't mistake them for vitamins.
I'm a PNP boy.
Party and Play.
Drugs and sex.
You don't approve? Does the sex include condoms? If he's negative, sure.
If he's positive Why put on a raincoat if you're already wet? You could get hepatitis, or another strain of HIV.
Or I could get hit by a bus.
AIDS isn't a death sentence anymore.
I don't wanna have any regrets.
How long have you been coughing? About an hour or so.
Try to take a deep breath.
What is it? I think it's blood.
I recommend post-exposure prophylaxis.
Your chances of conversion are slim, but I'd like to put you on three anti-viral medications.
Nelfinavir, zidovudine, and lamivudine.
There are side effects, headache, nausea, vivid dreaming.
You'll be tested for HIV at six weeks, three months, six months.
Very interesting.
He coughs infected blood in Cameron's eyes and mouth, that's interesting? The "coughing" part, not the "in Cameron" part.
New symptom, blood vessel ruptured in his lung.
I closed the tear.
Well, it takes immune reconstitution off the table.
What's it put on the table? It's okay, she's not here, you can skip the nice-guy acts.
You know, some human beings are actually capable of human feelings.
My giving a damn or not is not gonna change what happened.
Could be Goodpasture's syndrome.
No edema, no bloody urine.
Well, KS on his face could mean KS in his lungs, with bleeding from the lesions.
I would have seen them when I repaired the tear in his lung.
Wegener's granulomatosis? Wegener's would have responded to steroids.
Maybe you should go home, take the rest of the day.
I'm fine.
Well, this is good.
He's pretending to care, you're pretending not to.
I think we should reconsider drugs.
Kalvin uses crystal meth.
Concerned enough about his health to stalk me, while indulging in deadly street drugs.
A study in contradictions.
Interesting, but still not medically relevant.
It could be, if his drugs were tainted.
They cook meth with battery acid, lye, lantern fuel Find Kalvin's pills, test for toxins.
Foreman, you're with me.
I need a consult on another case.
We have another case? It's a hip-pocket deal.
Patient presents with a distinct neck tilt.
Wry neck.
Is he an athlete? He's a regular runner.
Any pain associated with movement? None that he's complained of.
Best-case scenario, an infection in the ear or lungs.
Worst case, brain-stem tumor.
You should do an MRl, CAT Scan, full work up.
I don't think so.
No insurance.
No drugs in here.
I'll take the bathroom.
How about a drink after work? Take your mind off what happened.
Cameron? I might have HIV, a drink's not gonna wash it away.
There's like zero chance of you contracting the virus.
Big difference between "like zero" and "zero.
" What did the infection control guy tell you? He was very reassuring.
Kept reminding me that the hospital covers all my medical costs.
Apparently forgot to mention that if I do test positive, that they'll pass it on to legal, and legal will dig up any dirt they can, trying to prove that I'm a drug user or tramp, and that's why I have HIV.
It's not like they're gonna find anything, right? Right.
Check this out.
Kalvin's a photographer.
The broken bulbs were props.
The glass is from Some of the bulbs are date-stamped.
Pre-World War ll, fluorescent bulbs contained large amounts of beryllium.
Beryllium dust inflames the lungs, they get rigid, patient can't breathe.
My father co-authored a paper on acute berylliosis.
Phew! For a moment there, I thought you were smart.
Cameron, get a biopsy of Kalvin's lung tissue, run a spectrographic analysis.
I can handle it.
No reason to risk exposing the entire team.
Then who would I torment? I'm sorry.
About what happened.
It's best not to talk.
You're gonna feel a sharp pinch.
This actually is gonna grab a piece of your lung.
What were you guys looking for at my hotel? Your drugs.
We thought maybe you'd used toxic meth.
We'll know if you were exposed to beryllium in a few hours.
Well, if you're still curious, it's in my bag over there on the chair.
You brought drugs into the hospital? Glad I wasted my time at your hotel.
I told you I used, you didn't ask me for a sample.
You're not pissed about this, you're mad because I coughed blood on you.
That was an accident.
Would you stop being nice? It's useless, and worse, it's boring.
Get angry! I had one stupid night, I end up with HIV.
Do you have any idea how pissed off I was? This wasn't your fault.
You broke into my house? Well, I had to, Mark isn't here.
He has physio.
Oh, really? How's he doing? What happened with all the cheese? Well, I had to get rid of it before Steve McQueen ate any Coumadin.
I named your rat.
Steve's tilting his head.
Any neurologist will tell you that suggests an infection or a brain-stem tumor.
Death cures both those things.
We can't kill him.
If it's an infection, it could be caused by something in your house.
Something that could affect you guys.
Smell this.
Does it smell like urine? You missing any asparagus? Okay, stuff these.
If he doesn't get better, then it's a tumor.
Then what, chemo? Steve McQueen without hair? It's a blessing he died young.
Hello.
Hi, honey.
I'm sorry I missed you, yeah.
I came home.
All right, I'll see you in a few minutes.
Okay.
Bye, hon.
Chest hurts.
Heart rate's a 100 and climbing, could be an allergic reaction.
Neck veins are up.
Must be pericardial effusion.
There's no wheezing.
The tear in his lungs must have reopened.
Kalvin? You're bleeding into the area around your heart.
I can't breathe.
The blood's crushing your heart.
Once we remove it, you'll be fine.
If I die, please tell my dad You're not going to die.
Tell him sorry.
Where's the blood? It's clear.
Only one other thing could cause this.
A tumor in his heart.
CT confirmed a mass in Kalvin's heart, and several smaller ones in his lungs.
That's why his heart's enlarged, not the AZT.
You okay? She's fine, probably getting bored with the question.
Masses in the heart and lungs, what kind of cancer are we looking at? They may not be cancerous.
This is classic Non-Hodgkin's lymphoma.
HIV-positive patient with a primary heart mass? It could be sarcoidosis.
His lung tissue was negative.
Lymphoma's a death sentence, sarcoidosis is treatable.
So is an ear infection, but since he didn't test positive for that either I want to do the Kveim-Siltzbach test.
Do you have any idea how much paperwork Cuddy's gonna need signed? Do it.
So How's the patient's father? "Tell my dad I'm sorry"? Might as well have waved a red flag at a bull.
He's not coming.
Well, it's not a tragedy.
Dad doesn't wanna see him, he doesn't wanna see the dad.
You're the only one who wants them together.
He asked.
He thought he was dying.
Dying people lie, too.
Wish they'd worked less, they'd been nicer, they'd opened orphanages for kittens.
If you really wanna do something, you do it, you don't save it for a sound bite.
What did you say when you thought you were dying? On the other hand His dad tossed him out.
So what's our guy wanna apologize for? Everybody has regrets.
If the growths in your lungs and heart are sarcoid, your body will recognize this material, and we'll see a reaction on your arm.
Did you really wanna see your dad? You called him? Thanks.
He would've come, tried to straighten me out.
How are you holding up? I'm fine.
Convincing.
What did you do with my drugs? The lab disposes of them after analysis.
Too bad.
They could've done you some good.
Not really my thing.
You know, I hope you don't have it, but Getting HIV might have been the best thing that ever happened to me.
I used to be a good boy.
Never wanted to piss anybody off.
Playing by the rules makes everybody else happy.
Now I'm happy.
So you just show up every time he's at physio? Of course not.
Also when he's at group therapy or out for dinner with friends.
And when she happens to mention to Mark that you dropped by You tell your wife everything? It's a process.
But Stacy doesn't have any reason to hide this from Mark.
As far as she knows, Mark's okay with you being there.
My bet is she mentions me to Mark as little as possible.
Because she thinks that he thinks that she still has feelings for me.
You know why she thinks that? Because she still has feelings for you? If you're right, she did tell him and I don't get through the door tonight.
If I'm right So how long do we stay here? Until something happens.
He's not gonna come out with us right here.
We are downwind, and he seems to have hearing loss.
He's not blind.
Steve McQueen does not run from danger.
Antibiotics, on the other hand He ate around the pill? Smart.
Admit it, you like him.
He's all right.
For a rat.
You wanna know how cool he is? His urine showed traces of hydrogen cyanide, formaldehyde, lead.
He's a smoker.
Your husband's been lighting up, which is particularly stupid, given that it could cause his AIP Okay, I blow my smoke into the vent so Mark doesn't know.
I always knew.
Bluffing.
You started two weeks after my surgery.
Menthols, then lights after a month.
Why didn't you say anything? 'Cause it helped me monitor your misery level.
One trip outside was a good day, and upwards of six, you were in hell.
You could have asked me how I was.
I already knew.
I'm sorry you were miserable.
Sorry I caused you so much pain.
Glad you changed your mind about that drink.
Come on in.
You should get changed, there's this new place on campus that looks Are you high? Uh-huh.
I thought the lab disposed of the drugs.
Not all of it.
Slow down.
Your pupils are dilated.
You're not Come on, Chase, don't turn into a good guy on me now.
You're late.
And hung over.
Or maybe not.
Why do you have a rat? Jealous? Get out of my room! Don't you dare put this on me! I'm not gonna grovel, Dad! That's not what I'm asking for! Like hell it isn't! You said you didn't call.
Well Don't mind me, just here for the show.
Yeah, well, there's not gonna be any.
What happened to the big apology? Yesterday he was all, "Daddy, I'm so sowwy.
" This is none of your business.
Well, you should've thought of that before you stalked me.
Now I'm interested.
So what's he got to apologize for? You're the one who tossed him out.
Now why would I do that? I don't know, because it's tough to brag to your hunting buddies that your son knows all the words to The Wiz.
That's a lie.
No.
Much easier just to get drunk and beat him.
Explains his hating you, and also your cirrhosis.
Also, why the more I talk, the more you sweat.
What it doesn't explain, is why he's got to apologize to you.
Residual guilt for sharing your special toy with other boys? Just leave it alone.
You just wanna leave the bigot with some peace of mind after you're gone? Look, this has got nothing, and I mean nothing, to do with him being gay.
Now Kal brought this on himself with what he did to his mother.
He steal her signature look? No.
No, he killed her.
Kalvin lied! Yeah.
That certainly is shocking.
Mom's kidneys were failing, she needed a transplant, they tested Kalvin, he was a match, he was also positive for HIV.
Mom never found a qualified donor, she dies.
Tragic tale.
Undercut slightly by the rapid-fire delivery and constant movement.
Too much coffee this morning? He didn't kill her.
Our bodies aren't donor farms for our parents.
It's not 1980.
We know how HIV is transmitted.
If Kalvin got HIV through unprotected sex, dad has every right to be pissed.
So you always use a condom? Yeah.
Brothers on the down-low got to.
I'm not ready for any Foreman Juniors yet.
You? Working girls are sticklers.
You're not gonna poll Chase? I'm not an idiot.
Obviously not.
Who doesn't sleep with a drugged-out colleague when they have a chance? Where's Wilson? We got the result of the Kveim test.
But so I have cancer? In all likelihood, yeah.
Non-Hodgkin's lymphoma.
And I am dying? We need to biopsy the tumor.
It's near your aorta, so getting that sample carries serious risks.
Is my dad still here? He hasn't been in? We'll inject a dye around your heart to make the tumor visible on the CT.
Then a surgeon inserts a guide wire, runs it up into your heart, where he takes a small piece of that tumor so we can look at it under the microscope.
Ativan.
It'll help settle you down.
Why are you so calm? Not coming off meth helps.
Last night probably shouldn't happen again.
Do you think I want it to? When two people have had sex, unless it sucks, if they can do it again, they're gonna do it again.
And that's when things get complicated.
And it didn't suck.
So now you've gotta drum up another excuse to be around the love of your life.
Could hit another patient.
Yeah, don't like to repeat myself.
People will say I'm formulaic.
Well, that rules out letting the rat go so you can catch him again.
I can't do that.
Steve needs two weeks' antibiotics and a smoke-free environment.
Cigarettes aggravated his infection.
The rat is actually sick? That thing could infect the entire hospital.
Steve's infection is not contagious to humans.
I'm an idiot.
How do I miss mycoplasmosis? Was that the kid's father? Yeah.
Remember the Black Death? It started with rats.
Well, what's he doing in the hallway? Is the kid getting his biopsy already? He just won't go in the room.
Who knows what else he has, parasites, bacterial infection? The kid doesn't have parasites.
Not the kid, the rat.
Was he still sweating? Rats only sweat through their tails.
Not the rat, the dad! Where are they from? Montana.
What's going on? You were right, it's a parasite.
Cancel the biopsy, it'll kill him.
Hey, Daddy, come with me.
Yeah, I'm not going in there.
Your son asked to talk to you.
Why is he here? He wanted to talk to you.
Did you two used to hunt together? Foxes? Did you kill foxes? It's Montana.
Those masses in your chest are not tumors.
They're parasitic cysts from a bug called echinococcus.
Touch a dead fox, they jump aboard, they can hunker down for decades.
Growing, spawning, shopping, putting on plays.
I've been tested for parasites.
Okay, it's cancer.
You happy? The cysts isolate the parasites, keeping them from showing up in stool samples.
Even in blood tests, cardiac All right, you don't need me for this.
But you've got the same things in your liver.
I have cirrhosis.
Liver cysts have identical symptoms, with one addition, fever.
And liver cysts we can test for.
Your diagnosis could confirm Kalvin's.
So, option A, we draw some blood No, no, no.
Look, you're not touching me.
Well, you see, this is why I need you here.
I want you to tell your son that you won't take a simple, painless blood test to save his life.
You never expressed a shred of regret for what happened to your mother.
Jeez, Dad.
If you'd have worn a damn rubber, you'd have been fine.
You could have saved her life.
You wouldn't be lying here.
Yeah, yeah, yeah, I get it! You're really mad at him for killing himself, and for destroying everything you love.
I don't have time for this.
Are you gonna apologize? I'm living my life the way I want.
Are you gonna give me some blood? Look, if he doesn't give a damn, then neither do I.
Okay, option B.
Why did your wife kill herself? Did she hate you? She was a diabetic! You know, you don't know a thing about my Susan.
Either Susan wanted to die, or she was both fat and stupid.
Used a Twinkie instead of a gun.
And girls with big appetites, well, they just can't get enough of anything.
Shut up! Probably nibbled on every Devil Dog in the county! Shut up! Just in case I'm not making myself clear, I don't mean the delicious snack.
You son of a bitch! Yeah? Come on! Thank you.
Means I can do this.
We're gonna need some epi in here, stat! Are you out of your mind? You said you didn't care.
Notice how you can't breathe? Now, either that's the cane or, I just ruptured one of those liver cysts we were chatting about, and you've gone into anaphylactic shock.
Exactly the same way your son did when he accidentally tripped against my friend's car.
I'm just so excited to find out which.
I'm gonna schedule the surgery.
Clamp.
Pressure's holding.
Give me the syringe.
Clamps Two successful surgeries, two lives saved.
I'm over my quota.
Can I have next week off? Two family members assaulted.
It was self-defense.
You baited him.
You're right, I was asking for it.
The low-cut blouse, the do-me pumps.
You flooded his gut with a parasite.
He could sue.
Go see Stacy.
Okay.
That's it, "okay"? No name-calling? No squawking, no rending of garments? I like this t-shirt.
You lied to me.
If this is about my mom, I This is about your lonely, miserable life.
I'm not miserable.
And as long as there's a gay bar around, I'm never lonely.
You haven't had a single visitor except for your dad.
Drugs are great, HIV freed you, your dad hates you, you're so happy.
Everything's a lie.
You blame yourself for your mom's death.
You're not trying to have fun, you're trying to self-destruct.
You wanna kill yourself, fine, but stop recruiting! Heard you hit another patient.
Yeah, sure, why not? He hit me first.
Cuddy didn't mention that.
Let me see.
I'm the doctor.
My concern is purely legal.
Looks okay.
Does it hurt? A little.
You need some ice.
There's no way that Mark doesn't know.
About the smoking.
He would have said something.
Then he hasn't been near you in months.
We're fine.
Can't be easy.
Stop squirming.
Why would you lie about this? I'm not lying.
I don't care if you're sleeping with him or not, but you're not, so I am.
You're lying.
You know when I have sex? You can smell that on me, too? The only people who know about what's going on with me and Mark, are me and Mark.
Well, I just know you.
And I know you.
You're confident, arrogant, but you're never certain unless there's a reason to be certain.
One other person knew.
I told you I was seeing Dr.
Harper, you can easily get into her office.
You read my file.
You read my file.
The dishes, the concern, the acting like a human being.
You have This whole time, you've been manipulating me.
You knew that I had an angle the moment I poured soap onto a scrub brush.
You could have thrown me out or ignored me or found another exterminator.
You didn't even tell Mark that I kept coming by.
You let this happen because you wanna be with me.
I don't anymore.
Get out.
I'm sorry.