House, M.D. s03e02 Episode Script

Mom! I'm thirsty.
I just gave you water.
I want juice.
It's bedtime.
Close your eyes and go to sleep.
Mom! What do you want, Clance? Oh.
Hi, Dad.
Go to bed.
Can I turn the TV on? TV's only for the daytime.
That was the deal.
I'll keep the volume down.
I just like the light.
Go to bed.
Dad, what if What if they come to get me again? Nobody is coming to get you, okay? Go to bed now.
Come on, Clancy.
It's time to get up.
If you plan to be out at the shore today, you are in for a treat.
We're looking at mostly sunny skies up and down the Jersey coast I guess he's already up.
That's a first.
Well, I'll see if he needs breakfast.
Hey, Clance, you hungry? Hon, he's not down here.
You sure? Clancy? Clancy? Clancy? Where are you? Sweetie, are you hiding? Clancy? Where is he? Clancy! Clancy! You're gonna be in big trouble when I find you.
Honey, come out right now, wherever you are.
This is not funny.
Clance? Clancy? Where's the sweat and the BO? You've taken such pride in bathing us all in your musk.
I showered at home.
And yet you're earlier than usual.
Is this an intervention? It's a little late, since I'm not using drugs anymore.
I am, however, still hooked on phonics.
If you did your morning run and showered at home, you'd be later than usual.
Thought of you in the shower.
How's your leg? You seem to be favoring your left side.
I was hanging down my right pant leg yesterday, makes all the difference in the world.
You've taken the stairs every day.
Do I need a restraining order? You slack on your rehab, the muscle will weaken, and your leg will hurt again.
Looks like the ketamine treatment might not stick.
Or maybe we've made him depressed because we're lying to him, telling him he got that case wrong.
We didn't hurt him.
The pain isn't He gets depressed, he stops exercising.
He stops exercising, the muscle atrophies.
The muscle atrophies, the pain returns.
Maybe he stopped exercising because the giant hole in his leg actually hurts.
The ketamine could work perfectly, and he would still be back on his cane, popping Vicodin again.
You can't tell him.
He got lucky.
There was no medical He was right.
We tell him he was right, and we're feeding his addiction.
Without Vicodin, he's only got one to focus on.
Well, he's not gonna OD on puzzles.
No, it's not gonna hurt him, but he could just as easily have killed that patient.
We have a tiny window of time here where House may be healthy enough to change, and based on that limp, the window's closing fast.
Kid is a product of an in vitro fertilization pregnancy, had all his vaccinations, fractured his right ulna at age three, chicken pox at age five He ever get his feelings hurt? I'll need to know that, too.
You are "0" for one since you came back.
We just wanna make sure that Rectal bleeding plus alien-abduction fantasies.
Most likely sexual abuse.
Penetration causes the bleed.
Trauma causes the fantasy.
ER ran a rape kit, found no evidence of tearing, semen or pubic hairs.
I think we should talk to the kid.
Why? In case he's telling the truth? You're a believer, aren't you? Well, I'm just not arrogant enough to think that of the 50 billion galaxies, and 10 million billion planets in the universe, that we're the only ones with life.
No, but I'm guessing we're the only ones who like shoving things through our back doors.
There is new research indicating a link between neurological problems and bleeding disorders.
Perfect, especially if there were neurological problems.
What part of hallucinating an alien abduction isn't neurological? It wasn't a hallucination.
What? You think the kid He's having nightmares.
Nightmares aren't a symptom of anything other than wanting to sleep with Mommy, which just leaves us with one symptom, the bloody tuchus, which can easily explained by a GI problem or bleeding disorder.
Check his coags with a PT, PTT and bleeding time, and prep him for endoscopies from above and below.
I'm gonna make a tiny nick in your forearm, okay? Then I'm gonna time how long it takes for you to stop bleeding.
Now, this is gonna sting a little, so you might wanna look the other way.
Are those windows locked? Those windows don't even open.
They're just here to let sunshine in.
Good, 'cause they know I'm here.
Clancy, don't bother the doctor with this stuff.
No, it's okay.
How do they know you're here? They put a chip in my neck so they can keep track of me.
I can feel it back there.
Clancy, you know there is nothing back there.
There is.
Let me see.
Lean forwards.
And they have this other thing, and they put it in between these two ribs, always on this side, and then they move it around my insides.
It hurts.
You know what, Clancy? I think I might have found the chip back there, and I think I might be able to get it out.
Really? Mmm-hmm.
Okay, lean forwards.
Now hold very still, okay? Got it.
I'm seven, not three.
All you did was pinch my neck.
Sorry.
His alien-abduction story, the level of detail is Well, I don't know where he gets it from.
The parents say he doesn't watch sci-fi.
He doesn't read comic books Great.
You do any of that medical stuff we talked about? Upper and lower endoscopies were clean.
So it's a simple bleeding disorder.
No, blood tests are all normal, and he clotted in six minutes.
So it's a simple bleeding disorder, and you screwed up the test.
I didn't screw up the test.
So it's a UFO.
Unidentified Flowing Orifice.
Either you screwed up the test, or I screwed up my analysis of this case.
If you screwed up, I don't have to cry myself to sleep.
It's a simple bleeding disorder.
Foreman, redo the test.
How could I screw up a simple bleeding-time test? Maybe you were abducted, lost time.
Kid's got a bleeding disorder.
Sure? I had to stop the bleeding myself after 25 minutes.
So you're saying Chase did screw up.
Or Foreman screwed up.
Big hand points to minutes.
Maybe you got it mixed up.
Oh, snap.
Foreman's playing the dozens.
You're at a huge cultural disadvantage here, Chase.
Take a couple of minutes to think of a witty retort.
So we have contradicting bleeding-time tests.
If we run labs to check his clotting factors, we can confirm which one's right.
Yeah, testing.
Nice idea.
Way better than trying to guess which doctor's incompetent.
Looks better in the paperwork, too.
Hey, Foreman, your mama's so fat, when her beeper goes off, people think she's backing up.
Where's Clancy? He's asleep.
He's House, Clancy's gone missing.
Oh, no! You take Alpha Centauri, Foreman can look on Tatooine, and Cameron can set up an intergalactic checkpoint.
Let's pray he hasn't gone into hyperdrive.
We'll never catch him.
Clancy? I had to go where there are no windows so I could get the chip out like you said.
God.
I can feel it.
I just can't grab it.
Clancy, stop.
There is no chip.
We're gonna clean you up, and we're gonna go back to your room.
You can't do things like this.
Your parents Results came back.
The lab cannot identify the metal.
Said it might not even be terrestrial.
Really? No, you idiot, it's titanium, like from a surgical pin, like the kind the kid had inserted into his broken arm four years ago.
Nice medical history.
That pin was removed six months So a little piece broke off during removal.
Titanium is used to build nuclear subs.
Pieces don't just break off.
Tell that to the guys on the Kursk.
And how exactly did it get from his arm to the back of his neck? Body attacks any foreign object.
Inflammatory reaction could erode it into a vein.
Fragment gets a free ride.
To his lungs maybe, not his neck.
Yeah, an alien chip makes more sense.
The real mystery is that you didn't actually screw up.
You okay? Fine.
Tripped.
Kid carved a hole in the back of his neck.
Apparently didn't bleed to death.
Now that's weird.
He clotted on his own? Sure did.
So first there was no bleeding disorder.
Then there was.
Now there's not again.
Which is impossible.
Or Foreman screwed up.
Two out of three tests agree with my findings.
Lucky for us, the fourth test will be the charm.
So you're just gonna keep cutting him? Until what? This test is different.
We'll draw some blood, and see if any clotting factors are low or missing.
But why haven't the other tests We've got three results.
They haven't been consistent.
One of them must be wrong.
Or two of them.
Is it possible the problem isn't his blood? It's just psychological? I mean, he almost killed himself.
He wasn't trying to hurt himself.
No, he was just looking for an alien tracking device.
I have time for one more.
Can't blame you for spending extra time down here.
I heard the Artist Formerly Known as Gimp is back upstairs.
Oh, Dr.
Cuddy wants that one.
She's busy.
I'll take it.
Oh, my God! You're You're okay! Have we met? I was one of your doctors.
You were in a vegetative state when you left here last week.
Addison's disease.
All I needed was cortisol, and my brain turned on like a switch.
This is amazing! Surprised you didn't know.
How would I know? Not quite my old self yet.
Baby steps, the doctors tell me.
Now With rehab, you'll do great.
What hospital did you go to? How would I I wanna have sex with my wife, and I was hoping that maybe you could Viagra? You're here for Viagra? A bucketful would be nice.
Dr.
Cuddy.
Hi.
It's completely unethical.
He was reckless with a patient.
He was right.
But he didn't know that.
He needs at least some glimmer of humility.
Why does he need that? Because other people have that? Why does he need to be like other people? He needs to be less reckless.
Well, you did it.
He's dismissing symptoms, looking for easy solutions.
He's in pain.
How much pain? Why? You know this is affecting him, don't you? Telling him that he got his last case right won't do anything to help him.
It'll make him less depressed.
Which might not help his leg.
But you don't know.
Just let me run a PET scan on his parietal thalamic area to see if it's sensing pain.
If it is, the ketamine isn't working anymore, and he's headed for a huge crash.
If it's not, the leg pain is my fault, and I will tell him the truth.
Too tight? My parents think I'm crazy.
No, they don't.
They're just worried about you.
That's all.
I'm not weird.
It's just that weird things keep happening to me.
Slight pinch.
If you make me better, do you think the aliens will leave me alone? I don't think they're gonna be bothering you for much longer.
Are you lying again? No.
We figure this out, everything's gonna be okay.
Still with us? Let's go.
Pulmonary edema, stage-two hypertensive crisis.
What is happening? Wait outside.
Get him oxygen, and start him on an IV drip of sodium nitroprusside.
Get them outside! He's in ICU, systolic is hovering around 170.
I left instructions to lower it slowly so we don't risk hypoperfusing his organs.
Trade-off being that leaving his blood pressure that high risks stroke, MI and blindness.
I'm open to suggestions.
Solve the case.
Kidneys could explain Kidneys are clean.
Tell me he's a mutant-human hybrid.
It is a bleeding disorder.
Clancy tested positive for Von Willebrand's.
I didn't screw up.
How could he clot on his own two out of three times? Maybe he cheated.
Right.
Kids always cheat on their bleeding-time tests.
She was being metaphorical.
She's trying to sound like me.
I have no idea what you meant, but I could smell what The Rock was cooking.
I meant, he's clotting right now, and he's in hypertensive crisis.
Maybe the two are related.
What if he was hypertensive the other two times that he clotted? Hypertensive crisis can activate clotting factors.
Even someone low on Von Willebrand's could theoretically clot.
And the first time Clancy clotted, he was all worked up recounting his alien abduction.
He could've easily been hypertensive.
I know I get worked up when I cut microchip tracking implants out of my neck.
Sounds like a cheat to me.
Yeah, we get it.
Okay, what's the differential for a seven-year-old boy suffering multiple hypertensive crises? We think the problem is in your son's heart.
We need to do a procedure called a transesophageal echo.
Okay, and that will fix his heart? That will tell us where the problem is, hopefully.
Then we can fix him.
Listen, this isn't really part of my job, but he's worried that you think he's crazy.
Well, isn't he? There are still plenty of other explanations for what's going on.
It's important he knows you believe in him, even if you don't.
It's clean.
His heart isn't the problem.
Why don't I have a high-def in my office? I'm a department head.
There are no structural defects.
Valves are intact.
Tissue characterization is impossible when the pixels are the size of Legos.
See, this is what I'm talking about.
Foreman, you gotta steal this thing for me.
Let me ring up one of the homies.
The clearer the image, the clearer it is that there are no masses, no clots, no tears.
The problem's gotta be somewhere else.
We're gonna need a bigger boat.
You're wrong, House.
Think he'll make us break into the IMAX before he admits it? There.
Where? Right there.
Left side, no movement.
Well, don't freeze it.
Something's not moving.
How do you see something not move if nothing's moving? I need a laser pointer.
We don't have a laser pointer.
Well, why not? Who's gonna take us seriously if we don't have a laser pointer? Right here.
A few thousand myocytes not beating with the rest.
So you've found an arrhythmia? That's not an arrhythmia.
That's a no-rhtyhmia.
Myocytes contract.
These aren't moving at all.
Go get me those myocytes.
I wanna talk to them in my office.
How's the kid doing? Heart nearly exploded.
Still beating, though.
Most of it, anyway.
Why do they bother putting age restrictions on these things when all you have to do is click, "Yes, I am 18?" Even a 17-year-old can figure that out.
What's going on with the leg? First, tell me what's going on with the boobs.
If you're feeling pain They're firmer.
It's called an underwire.
I wanna get a PET scan of your brain.
I think it's hormones.
As long as there's no increased activity in the thalamus Looks to me like those puppies are going into the dairy business.
then the pain can be good.
It could be muscle regenerating.
After you workout, you get sore.
Pain doesn't mean the ketamine failed.
Guess I should be saying, "Mazel tov.
" Who gets to pass out the cigars? I'm not pregnant.
I need to get a PET scan of your brain.
Boy or girl? You got a name picked out? I'm not pregnant.
My leg doesn't hurt.
You're in denial.
No, I'm not! Oh, you got me.
If I thought that my leg was deteriorating, don't you think I'd want to take steps to prevent that? Okay.
Gotta go.
Here's Clancy's DNA.
And here's the DNA from that piece of his heart we just biopsied.
That is impossible.
Run it again.
We already did and once more after that.
The genes from Clancy's myocytes don't match the genes from the rest of his body.
Alien DNA.
Anybody watch any X-Files that inspired an explanation? There are ways DNA can become mutated.
Extreme UV radiation.
That much sun, he'd be dying with a healthy bronze glow.
Nitrous acid or ethidium-bromide exposure.
First, Daddy was a rapist.
Now he's a chemist.
Various species of fungus have been proven mutagenic.
Not unless the kid's been eating barrels of celery or living in Indonesia or both.
Is your leg hurting? Is that question helping? You're leaning.
You're sitting.
You're evading.
My head's hurting.
Please, someone, give me a plausible, terrestrial explanation for this kid's alien DNA.
We could search his home for toxins, fungals and radiation.
Who cares what caused it? A kid comes in with strep, we don't conduct a search to see which classmate he got it from.
We cure it.
We know he's got the stuff inside him.
Let's get a scalpel and cut it out.
Where do we cut? Chances are, it's not just in his heart.
Well, we got lucky with the heart.
Myocytes contract.
We could see that these weren't working.
I don't know how the hell we're gonna find it anywhere else.
What if we take the heart cells with the bad DNA, and we tag them? Can you phrase that in the form of a metaphor? It's the same way we search for cancer.
The bad DNA creates a unique protein on the surface of the affected cells.
We create an antibody that recognizes only that protein, we flush it throughout his system, and the similar cells light up like light bulbs.
Okay, let's do that.
You have to tell him.
He said he wasn't in any pain.
He's lying.
Of course he's lying.
We need another plan.
Don't talk about it that way.
What way? "Plan.
" It sounds like we're conspiring against him.
I'm gonna tell him.
No, you're not.
Then come up with a cunning plan and fast.
She's not nearly as delightful as she thinks she is.
What's this machine do? Makes a lot of noise, and it's gonna help us figure out what's wrong with you.
You think House has lost a step? He's fine.
There.
Clump of affected cells in the bone marrow of the femur.
Explains the intermittent-bleeding disorder.
'Cause I don't need to subject myself to House's torture if there's no upside.
I'm telling you, he's fine.
We missed some affected cells in his heart.
Explains the continuing hypertensive issues.
You said the last case really threw him, and now suddenly I was wrong.
So you changed your mind.
Why? His brilliant ideas on this case have all been yours.
There's the reason for him needing glasses.
Apparently, it's a symptom.
It means the condition predates You don't change your mind without a reason.
Now, what do you know? House didn't blow the last case.
Cuddy cured the guy using House's idea.
Cuddy and Wilson are trying to teach him some humility.
Scan is complete.
Three hot spots, but nothing in his brain.
House's original theory was right.
It is not neurological.
Is he going to be able to walk? His leg should be functional after some rehab.
"Functional"? What does that mean? He'll be able to walk, but not run? He'll have a limp? If everything goes well, he'll walk.
He'll run.
He'll probably be even stronger than he is now.
When we close him up, we'll move over to his other leg, snake a catheter up through the femoral artery and into his heart.
Once the affected areas are removed, his normal tissue will step back in, do its job.
He should have no more problems with his blood pressure.
After confirming those areas are clear, we'll start the final procedure.
We're gonna insert a needle through the pupil and get rid of the abnormal cells in the retina.
Close your right eye.
Can you see my face? Yeah, it's clear.
You can throw away your glasses.
We got it all.
Get some sleep.
You're going home tomorrow.
Thank you.
Do you wanna go for a run? What do you want? I want you to run.
When did you become an enabler? I'm enabling you to exercise.
Vicodin blocks the pain, you get through your rehab, muscle strength increases, and pain decreases.
I'd rather not become dependent on pain pills to get through my day.
You're just like any other patient, running away from knowledge that won't make you happy.
I'm as happy as a pig in poop.
You're scared the ketamine treatment's wearing off, that it was just a torturous window to the good life.
What part of "poop" didn't you understand? How can you be so sure it isn't just a sore muscle? It's my leg.
We've known each other a long time.
You're not always right, House.
You've proven that lately.
What's happening to him? He's seizing.
I need clonazepam.
I thought you got it all.
Yeah, yell at me.
That'll fix your kid.
Obviously, we missed some foreign tissue.
There's something still in him.
The hallucinations and seizures indicate problems in the temporal lobe.
Sorry, House, it is neurological.
Looks like you're wrong again.
We didn't miss anything.
Brain scan was completely clean.
Our tag must not have penetrated the blood-brain barrier.
Don't use an IV this time.
Get it right into the brain.
No cells are lighting up.
His brain is clean.
It is not neurological.
His symptoms are neurological.
His condition has to be neurological.
His scan was clean twice.
It's not there.
What if it is there, but didn't show up on the scan? What if the tag just doesn't work in his brain? Brain cells are structurally different, express a different protein.
So how do we find it? Where are we going? I am going to think.
Send the kid home.
What do you mean? Make sure his blood pressure's stabilized, and send him home.
What, like nothing ever happened? We cured his bleeding disorder, removed all the damaged cells we could find.
We don't know that we fixed anything.
It's only been a day.
Maybe these symptoms come and go like the blood disorder.
It's more probable that his remaining symptoms are just a nightmare.
He had a convulsion.
May be epilepsy.
May be psychological.
May be nothing.
If the kid gets sick again, it'll give us another clue.
We can start searching again.
If he doesn't, doesn't matter.
Send him home.
House.
You're just giving up on this kid? You gotta know when to stop.
You don't stop.
You never stop.
You just keep on going until you come up with something so insane that it's usually right.
Except on my last case.
Don't be pathetic.
Just forget the last case.
This kid obviously has something wrong with him.
When did you develop such strong opinions about my patients? Last week, you were convinced my patient wasn't sick.
Now you're convinced this one is.
This one is a young boy.
His parents are desperate.
Just get together with your team, spend a few extra hours Well, I guess we could amputate his left leg.
That's where we found most of it.
Maybe we should just remove his affected eye completely.
If you have reason to believe that that might help I'm not gonna start lopping off body parts, but it's interesting that you give me the green light.
I just want you to do something.
You've been overly supportive this entire week.
Either you're hormonal, or you're guilt-ridden, and it's too early in the pregnancy for this to be hormonal.
I'm not pregnant.
Then what did you do wrong? He had Addison's.
Your last patient.
You were right.
I gave him one shot of cortisol and he woke up like Rip van Winkle.
Oh, your mommy is in such trouble.
She's such a liar.
That's why you don't have a daddy.
That's why she had to How does one person end up with two different sets of DNA? We've been through this.
Our assumptions are faulty.
We've confirmed two different sets of DNA.
We re-ran the sequence.
I didn't say the lab work was faulty.
I said our assumptions were faulty.
We assumed he's a person.
Of course.
The aliens didn't just visit him.
They replaced him.
You're being silly.
What if he's not a person? What if he's two persons? I'm not getting the metaphor.
No metaphor.
Chase, you said the mom used in vitro fertilization, right? Yeah, they had trouble conceiving.
Kid was right all along.
He was implanted with something, back when he was young.
I mean really young, like 12-cells young.
In vitro increases the likelihood of twinning.
But he doesn't have a twin.
Not walking around.
But in vitro fertilization costs around 25 grand a pop, so doctors implant two to six embryos to make sure you get your money's worth.
Problem is, there's not always enough bedrooms for all the kiddies.
Two brothers get stuck sharing.
There's no bunk beds, so they cuddle up to keep warm, and they never untangle.
He's two people in one.
It's called chimerism.
Unfortunately, his brother's like a bad doubles partner.
The guy just takes up space, gets in the way.
Clancy's body thinks that he's gonna put away the easy winners.
His brother just keeps swatting balls into the net.
We gotta get him off the court.
So does that mean that you can find the bad cells in his brain or not? Sure, abandon the metaphor.
Fine.
Clancy thinks differently than his brother because he thinks.
If we induce an alien abduction Wait.
What the hell are you talking about? The foreign DNA has got to be in a portion of your son's brain that makes him believe that he's being abducted.
If we stimulate those neurons with an electric probe, we can trick your son's brain into hallucinating.
Your son's neurons will light up, and his brother's cells will remain dark.
Those are the ones we cut out.
You're talking about brain surgery.
I'm talking about really cool brain surgery.
One of your sons will die, but the taller one won't be so annoying anymore.
So I have a twin? Not really.
What's on the card? A light bulb.
Start us out at 10.
I'm not doing that.
That was all me, kid.
Sorry.
You're in motor function.
Try two centimeters back.
He lives inside me? Sort of.
That tickles.
Stop tickling my feet.
You're in sensory.
You're getting closer.
What do you see on this one? Moon and stars.
So I am kind of weird? We're all kind of weird.
No! Clancy? We got something.
What do you see? The light.
Here they come, I think.
Brain waves indicate a mild hallucination.
Neurons are lighting up.
Any dark spots? Area's too fuzzy.
Hallucination isn't strong enough.
Turn up the juice.
His blood pressure's already Riding the short bus is better than not breathing.
Take us to 100.
Area's still too fuzzy to make any kind of distinction.
Crank it up higher.
You've already exceeded the preset maximum.
Next step's brain damage.
They're gonna get you.
They're coming through the walls.
They're gonna take you, torture you.
You'll never see your parents again.
Clancy? Can you hear me? Clancy? You got them.
Yep.
We got them all.
Close him up.
Everything's gonna be normal again.
You believe what Cuddy tried to pull? What now? She lied to me.
She cured my patient with my diagnosis, then lied to me about it.
That doesn't sound like her.
You're right.
Does sound like you, though.
What exactly did Cuddy tell you? Nothing that your body language isn't telling me right now.
So what was the plan? I'd feel so humbled by missing a case that I'd reevaluate my entire life, question the nature of truth and goodness and become Cameron? Something like that.
More that if we told you the truth, that you solved a case based on absolutely no medical proof, you'd think you were God.
And I was worried your wings would melt.
God doesn't limp.