House, M.D. s03e11 Episode Script

You okay? Yeah, just got clipped with a beam.
What the hell do you two think you were doing? We thought we heard someone in there! You never go in without authorization! Captain, this is all me.
Amy just followed me in.
So torching your ass last year wasn't enough, huh? You need to stop trying to prove how tough you are before you get yourself killed.
Yes, sir.
Let the paramedics look you over.
Come on, Derek.
Let's get this ladder to the second story.
Let's go.
Derek! Derek! Derek! What's happening? I'm freezing.
I'm fine.
ER docs don't think so.
Your temperature's been going up and down like a rollercoaster.
How old are these skin grafts? Last one was about six months ago.
We're gonna run some tests and we'll get a consult with Dr.
House.
I'll be fine.
You'll be doing what the doctors say.
Got it? I'll check in later.
Hey.
The way you covered for me last night He's my brother.
I know how to eat it from him.
I'm gonna stop by after my shift, okay? Okay.
So where is this Dr.
House? Speaking engagement.
Not guilty.
And on the charge of gaining control of said medication by fraud, how do you plead? Not guilty.
Very well.
Preliminary hearing is set for the 19th at 10:00 a.
m.
, at which time I'll determine whether there's enough evidence to proceed to trial.
Next case on the calendar.
People versus Williams.
Charge is assault in the second degree with intent to cause injury to another person.
I see the defense has submitted a motion to dismiss You gonna go talk to him? I was just gonna ask him where he gets his hair cut.
They have your signature in the prescription log, a security camera video, and a pharmacist's sworn statement saying you stole a dead guy's pills.
You're already looking at 10 years.
You wanna add a witness intimidation charge? Go ahead, ask him about his hair.
He suffered third-degree burns over 54% of his body, a year ago, and arrived in the ER last night, disoriented and shivering.
For 12 hours his temperature was bouncing between 96 and 102.
Why don't you contest the search of the pharmacy records? Yeah.
You could argue it violated doctor-patient confidentiality.
Except he wasn't the patient or the doctor.
He was the guy who stole from the patient and the doctor! This was the third time he'd been disoriented in the last two weeks.
Running into smoke-filled burning buildings can be a bit disorienting.
Fortunately, I have the cure.
Stop doing it.
He's not in a burning building anymore, and he's still shivering.
A hypothalamic tumor could cause a vacillating temperature.
So could ER nurses who were too busy to notice that a patient likes both hot coffee and cold sodas.
He tested negative for Hep C, TB, HIV, Lyme, and his tox screen's clean.
In case you hadn't noticed, not exactly in the mood to dance.
I'm not asking you to dance.
I'm asking you to do your job.
EKG showed arrhythmia.
Probably just a mild heart attack.
No chest pain.
And smoke inhalation already explains the arrhythmia.
The guy was in the burn unit for six months and had multiple surgeries.
Could be a hospital-acquired infection.
Maybe MRSA.
Works for me.
Draw a blood culture, start him on antibiotics, vancomycin plus broad gram-negative coverage.
If you called to see the design for my prison tats, they're still in R and D.
You need to talk to Tritter.
Not according to my lawyer.
Your lawyer isn't gonna be able to get the DA to drop the case.
Tritter can.
Yeah, you know what else Tritter can do? You are not impressing anyone! You may call yourself principled, but what you really are is a stubborn adolescent idiot! This isn't his fault! I'm not the one who You used the rectal thermometer on him.
You insulted him instead of apologizing.
You flaunted your drug use in his face and you refused to accept a deal I accepted the deal! Not until after you stole a dead guy's pills! Allegedly.
Tritter has been opening doors for you every step of the way and you keep slamming them shut.
There are no more openings to give, House.
If you wanna stay out of prison, you got to make one for yourself.
It's Vicodin.
You function better on it.
Talk to him.
MRSA's a bacteria that often infects hospital patients.
The burns on your chest and arm exposed raw flesh that made you a wide-open target.
But the antibiotics would take care of it, right? Depends on what strain it is.
We'll know more once we get the results back from these cultures.
So this MRSA thing, would it make everything look blue? He's seeing blue.
Who'd you get the scrip from? Cuddy.
You wanna know what I gave her? MRSA wouldn't change his ocular palette.
Heavy metal poisoning could cause vision changes, particularly thallium.
If it was thallium, he'd be losing his hair.
So maybe it's menopause.
He's 28 years old.
Yes, his age is the reason it's weird that a man has menopause.
Male menopause.
High estrogen, low testosterone.
Explains the temperature swings, disorientation, endocrinologically similar to female menopause, but without the vaginas and the mahjong tiles.
Male menopause doesn't explain the blue vision.
Blue vision isn't a symptom.
It's a side effect of Viagra.
It's right there on the label, which I'd had no reason to have read, except that I'm a doctor.
He's not taking Viagra.
You mean he didn't tell you he was taking Viagra.
I don't care how sick he is.
Trust me, he still thinks he's got a shot.
Menopause causes temperature swings, limpness, limpness causes pills, pills cause the blues.
He's presenting no other signs of premature aging.
Aging's not the only cause.
You said that he's got burns on 54% of his body.
Sure it's not 55%? Burns to his genitals could cause testicular trauma.
Which could in turn cause Run a hormone panel.
When it comes back positive, pump him full of testosterone and send him home.
Stop following me! Thank God my parents are dead.
If the old man had heard I had menopause, I'd never live it down.
It's nothing to be ashamed of.
Once these testosterone pellets dissolve, your system will be back to normal.
Yeah, but until then I'm an old lady.
Okay to come in? It's not MRSA.
He's not being isolated anymore.
Anyone not in a white coat is welcome.
You're looking better.
How you feeling? I'm good.
It turns out I got some hormone thing.
They're fixing it right now.
Are you okay? Yeah, I think so, I just Derek, are you in pain? You need to get these out! Okay, hold on, what's wrong? Get these out! What's going on? Looks like an allergic reaction.
Hold on! We're going to get you something to stop it.
It's okay.
No, just take them out! But you've got to calm down.
It's okay.
Get them out! Derek! Get them out! Derek, let her go! Derek, let her go! Two milligrams of IV lorazepam, stat! Get them out! The complaint department is across the hall.
I'm busy.
Can I just assume that you told me how unfair I'm being and I'm sorry.
You could throw a dart at all the adjectives between arrogant and unhinged, and I'm sure you'd hit one that describes me.
There's a reason I operate that way.
I live in pain.
Pain that on good days is merely intolerable.
And on bad ones will suck the life force right out of you.
It doesn't mean that I've handled this right.
Actually, it means I was wrong.
Thank you.
I know that couldn't have been easy for you to say.
Even if you don't mean a word of it.
I'm sorry.
Look, you can hook me up to a damn polygraph And I'm sure you'd pass.
The thing is I've never been interested in what you have to say.
All I care about is what you do.
I'll see you at the hearing.
It wasn't the medicine.
Contamination and allergy tests both came back negative.
There was nothing to suggest a pulmonary embolism.
And his EKG showed the expected tachycardia from the exertion of the attack.
And I'm fine, by the way, thanks for asking.
Aggression comes on that fast has got to have a neurological basis.
We should do a CT for a frontal lobe tumor and an LP for meningitis.
Great.
Have at it.
That's it? No challenging our theory, no tearing us down? No need.
You got it under control.
Where are you going? Upstairs this time.
To do what? Check myself into rehab.
Did Tritter offer you another deal? Nope.
This is all me.
So, no slaps on the back? Encouraging words? We're just trying to understand what this is.
I hope it's me detoxing, otherwise I soiled a perfectly good pair of underwear last night for nothing.
So this is for real? It's not just a show for Tritter? Absolutely it's a show for Tritter.
And the judge.
And, unfortunately, unless it's real, there is no show.
Hey, if it doesn't help my case, at least I can go to prison with heightened senses.
All the better to enjoy my strolls around the yard.
Time's up.
Group's starting.
Gonna need to check that stuff.
When I lead the big patient rebellion, Voldemort here is the first to go.
CT was normal, no frontal lobe tumor, LP was negative for meningitis.
We're back to square one.
What about something vascular? Polyarteritis nodosa? Brain lesions would have shown up on the CT.
Legionnaire's explains the chills and temperature.
Altered mental status causes the aggression.
We would have seen respiratory problems.
We're throwing darts.
We need to go to House.
We need to deal with this ourselves.
He can make the time! Derek's still his patient.
The man's life as he knows it could be over.
I think you of all people would want to cut him some slack.
We're treating a man who runs into burning buildings for perfect strangers.
He didn't ask for what's happening to him.
House did everything to himself.
He's been cut more than enough slack.
Right now, House has more important things to deal with.
It was the first time I'd seen him in months.
I guess I was hoping he'd put his arms around me and tell me he understood.
But he said he wasn't ready to forgive me.
Well, he may never be ready.
You're doing the only thing you can do.
You're trying.
How about you, Greg? Have you thought about how to fix things with people in your life? No need.
The people in my life have no expectations of me.
Makes all our lives easier.
Apparently not.
The first step in recovery Is admitting I have a problem.
I've obviously done that or I wouldn't be here.
I've even embraced step two and accepted that there is a higher power.
Maybe not a god per se, but that André the Giant guy was powerful.
Where I start to butt up against it is step three, surrendering my will to this higher power.
I'm sure André's ghost has my back and all, but my free will, I never leave home without it.
Kind of like your pills.
If you could do this on your own, I assume you wouldn't be here.
True.
Everybody lies.
His tox screen.
It's been clean every time.
Exactly.
It shouldn't be.
He's had extensive skin grafts, which hurt like hell.
Not everybody's House.
People can handle pain without medication.
But they do have pain.
This guy's worried about losing his job, so he's hiding the pain.
We find out where the pain is, maybe we find out what the problem is.
Or he doesn't feel pain.
Either way, it's something.
When? Two minutes ago.
Pulse is 157, respiration 42.
He was fine.
He was just telling me a joke, just a minute ago Get her out of here! No fluid in his lungs! O2 stat's 85.
He's hypoxic! We're gonna have to intubate! It's not his lungs! He's got marked ST elevation.
He's having a heart attack.
Pick a color.
Medication time.
"You are a ray of sunshine on a cloudy day.
" He's stable.
Won't stay that way.
His blood tests showed troponins and CK-MB up.
Chase was right.
He was hiding chest pain.
He's been having a whole series of heart attacks.
Heart attacks can't cause you to reach out and choke someone.
Lack of oxygen to the brain causes disorientation.
Increased adrenaline causes rage.
The more important question is what caused the attacks? Where are you going? To see House.
We have a 28-year-old with clean arteries, no valvular abnormalities having multiple heart attacks.
I'm not gonna wait for Chase to give us another breakthrough.
Maybe we should go.
We don't have an answer yet.
I'm fine, by the way.
Thanks for asking! Whoever came up with buprenorphine to wean off Vicodin should be shot.
Then stabbed in the eye.
I think someone needs to adjust my meds! The heart shows no signs of inflammation or If the cause of the heart attacks isn't internal, it must be external.
Something environmental.
None of the attacks happened in the same place.
Still must be something in common.
First one happened in an apartment building fire.
Fire, water, smoke, oxygen masks The second and third ones happened here.
There was no fire, no water, no smoke.
His clothes were all different, he'd been cleaned.
That's the "whats".
How about the "whos"? His partner Amy was at all three attacks, but Anyone else? People don't cause heart attacks.
Well, then you shouldn't be worried about proving me wrong.
Amy? Would you come with me, please? Anything new on my brother? We're not quite sure yet.
Could you come with me? Yeah.
What's this all about? I don't know.
They wanted to talk to us together.
Derek! House was right.
I don't get it.
How can I be causing his heart attacks? You may be carrying an agent that triggered them.
It could be anything, mold spores, poisonous plant residue, something you picked up at a fire site.
Until we identify the agent, we can't allow you near Derek.
I can't believe that I'm doing this to him.
You can't blame yourself for this.
You know how he got those skin grafts? He was trapped in a fire.
We were clearing rooms in an office building fire.
And the ceiling collapsed, and it cut me off from the rest of the group.
And I kept yelling that I was fine, but Derek refused to wait for the team to clear the debris, so he took off looking for another access point.
He got caught in a backdraft.
He almost died because of me once.
And now it's happening again.
You're not my mom.
You don't have to keep checking up on me.
How you doing? Not bad, considering I've just learned I'm completely powerless.
See this big fancy wing? It was built because this program works.
Faulty logic.
This big fancy wing exists because some people with money think that it works, wanna believe that they can buy a better world.
This is nothing short of idealized despair.
Let other people wallow in it.
I don't even know what that means.
None of this means anything.
It's just nonsensical slogans and platitudes.
Meaning takes time, it takes work.
What do you think I've been doing? You've been here for two days! Talk about wallowing in it! We all get it.
We know how much pain you have.
You're here to deal with that and get on with your life! Right! I should have an affair with a dying patient and move into a hotel.
You're a coward, House.
You find fault in everybody because you're afraid to look at yourself.
Thanks.
I was running short on platitudes.
You can leave now.
We tested Amy for about a dozen different agents, but they all came back negative.
So she's not causing the attacks.
Derek, are you in love with her? What does that have to do with anything? Amy told me how you got those skin grafts.
And the way you're always watching out for her, and I see the way you look at her.
Have you told her how you feel? She has a six-year-old daughter.
Women with daughters can still fall in love.
I know.
Because she did.
With my brother.
They're engaged.
Broken heart syndrome.
He's in love and it's killing him.
I thought that only happened to 80-year-old widows.
Thanks to his menopause and estrogen level, he basically is an old woman.
BHS is an acute physical response to an emotional experience.
Stress triggers a flood of catecholamines That's a plain old stress cardiomyopathy, not a heart attack.
But if you're too worried about losing your job to get it treated, they can devolve into full-on heart attacks.
You think it's a coincidence this started when Amy got engaged? No, I don't.
But now that you know the "why", what are you gonna do to stop the "how"? I already put him on beta-blockers and nitroglycerin.
No effect.
We need to put him on antidepressants.
Not if you're right.
Antidepressants would inhibit his autonomic nervous system, which would only speed up the heart attacks.
We could try propylthiouracil, slow down his metabolic rate.
Thyroid effect would only weaken the heart.
The only other option is blood thinners.
This is not a fat guy with plaque-filled arteries and a swollen heart.
He's a guy whose brain is trying to kill his heart.
So buy him a girlfriend, make him happy.
That might make you happy.
The only thing that'll make him happy is Amy.
So keep him away from her.
He has a myocardial infarction every time she walks in the room.
What do you think will happen to his heart when we tell him he can never see her again? He needs a shrink.
Chase's idea is as good as any.
But short of frying his brain and wiping Amy out, he's screwed.
We need Cuddy.
Why? So you can tell her why you need to fry a guy's brain.
The guy's heart isn't working and you want to shock his brain.
Electroshock therapy is the only way to erase his memories of Amy and stop the brain's chemical attack on the heart.
This isn't 1940! The problem can be controlled with antidepressants.
Cameron? Antidepressants would inhibit his autonomic nervous system, speed up the attacks.
LMNO, PTU, blood thinners, none of them will solve this problem.
The man's got a real-life Harlequin Romance in his head.
We're gonna pull out the 1940 playbook.
Bilateral electrodes, high-stimulus sine-wave intensity, turning that dial all the way to 11.
It's basic brain chemistry.
We interrupt protein synthesis, altering the neurotransmitter system.
End result, no memories, no Amy, no problem.
Go ahead.
You heard the lady, go plug him in.
Am I really that pathetic? What are you talking about? If I had pitched electroshock therapy as a cure for broken heart syndrome any other time, you'd have dug in, made me try a hundred other useless things first.
So either you're actually beginning to trust me or you just feel sorry for me.
You presented a reasonable argument.
You were clear-headed and non-impulsive about it.
Never once used the word "moron.
" The rehab's working, House.
You'll still be able to perform routine functions like walking, talking, tying your shoes.
The treatment targets the anterior cingulated cortex.
It should only affect your experiential memories.
So my parents? My childhood? If this works, you won't remember them.
Or your firefighting training.
And Amy.
Are you okay with that? I wouldn't miss her, right? Tell Amy how you feel.
Because if she loves you No.
I won't do that to her.
Or to my brother.
You're effectively killing who you are just to keep this secret.
She doesn't love me.
Caterpillar? Lower intestine with ulcerative colitis.
You crash art therapy classes just for the adrenaline rush? Cuddy wouldn't get off the phone until I promised I'd come and see for myself.
I got to admit, this move I did not expect.
Well, don't tell anyone, but the photos of smiling people in the brochures, it's just marketing.
Well, you're obviously making an effort.
So I suppose the next step is for me to talk to the DA.
Which you have no intention of doing.
No.
So words mean nothing, actions mean nothing, what the hell is left? You son of a bitch! What about your words, your actions? "Got to get House cleaned up.
Got to get him to show some humility.
" But when it comes to actually doing something, you prove that all you care about is bitch-slapping a guy who refused to kiss your ass! You ever trust an addict? You ever give one the benefit of the doubt? How many times did that work out for you Yeah, I get it.
And so you were screwed over by your wife, your mother, your partner.
But you keep sending them Christmas cards while you take it out on everyone else! No more Christmas cards.
No, I learned.
People like you, even your actions lie.
I'm scared.
I know.
I'm gonna give you a muscle relaxant so your body doesn't convulse.
Count backwards from 10.
Ten, nine, eight, seven Go.
What's your name? Derek.
Heart sounds good.
Do you know what city we're in? No.
Would you be okay with a couple of visitors? Derek, it's me.
Brock.
I'm your brother, and when you get out of here, you'll be staying with me.
I'm Amy.
I'm your friend.
I'm sorry, but I don't remember either of you.
We've given him four rounds of electroshock.
The charge made his voice a little higher, but the EKG and BP are good.
Good.
We're gonna give him his last round in the morning, then be in court for your hearing.
Thanks.
I'm gonna stay here.
Monitor Derek.
Thanks for the update.
My next condolence call is arriving.
I'll see you guys tomorrow.
I got you something.
Nice.
I figured it might help make a good impression on the judge.
It's not that nice.
I had no business blaming you for any of this.
I know you were just trying to help me.
Protect me.
That's what friends do.
Is this an apology? Part of the program.
If you don't like it, I can stop.
Not at all.
It's just so unfamiliar.
Please, keep going.
He looks lost.
It's gonna take him a while.
Brock's pulling a double shift.
He can't stand to see him this way.
Derek's gonna need him, Amy.
I know the timing isn't great with a wedding coming up.
What wedding? Yours.
You and Brock.
We're not getting married.
We don't even date.
Why would you think we're getting married? When you first offered Dr.
House the chance to check into drug rehab, how did he respond? He told me to get out of his office.
I warned him that he could end up in prison and lose his medical license.
If he was concerned, he didn't show it.
So you continued your investigation? Yes.
Which is what led me to the hospital pharmacy.
Turn it off.
What did you tell the pharmacist was the reason for your visit? I thought I told you never to call me when I'm on trial.
The memories were false.
We fried his brain for nothing.
Whatever was killing him before is still there.
We did an MRI.
There's slight hypo-perfusion in the anterior cortex.
What did you find when you checked the pharmacy log? Hold on, Mr.
Vickers.
Thanks, Your Honor.
It's hard to hear.
Did you test for clotting time and LV function? I believe that this is a medical emergency, Your Honor.
His blood's normal and his heart's pumping it up to the brain.
But it's not all getting there.
Something's obstructing the blood flow Dr.
House, you were given adequate notice to make arrangements for your patients.
There's no hyper intensity to suggest a foreign body near the region.
And no signs of infection or vascular malformations.
It's lower down.
Dr.
House, hang up! The cytology on the LP doesn't suggest a tumor.
Now! Hang on a second.
Does your voice always get that high and annoying when you're angry? Do you want to go to jail? No, thank you.
Set him up for a selective vertebral angiography.
I'm on my way.
Dr.
House.
House! Sit down! Why? I'm bored.
There's nothing I can say or do that's gonna make a difference here.
If you leave this room, I will find you in contempt.
Get a recess.
Are you out of your mind? They said they wanted me there, but I don't think they like me.
His voice isn't high because of the electrical charges.
It's another symptom of menopause.
His system keeps getting hit by women's issues, so let's follow the pattern.
What might obstruct the blood flow that's more common in women than men? Is the catheter in? Go back to court.
We'll let you know the results.
Shut up and wire him.
Center the image on the interpeduncular cistern.
Keep it moving at If you think the arteries are narrowing, you're gonna need still shots, which we can do without you.
The problem is not how wide the road is.
There's a guy with a squeegee on the sidewalk flagging cars.
That's what's causing the slowdown.
We find him, we find the problem.
He's wired.
Go! Injecting the dye.
Blood's in the capillaries.
There.
Mr.
Squeegee.
Spinal meningioma pushing on the nerves to the vocal cords creates the voice change.
And that nerve just happens to live right near the meningeal branch of the vertebral artery, obstructs the blood flow to the brain.
The brain malfunctions, creating false memories.
Memories cause love.
Love kills.
And we didn't completely screw up.
Cleaning the slate bought us time to find the real problem.
On the other hand, if we had been better, we wouldn't have needed the time.
Schedule him for surgery.
Dig that thing out.
He can start enjoying real misery instead of the fake stuff.
House.
I just heard that you apologized to Wilson.
Detoxing.
I didn't know what I was saying.
Excuse me.
I have to go to jail.
What is your position at Princeton-Plainsboro? Chief Administrator and Dean of Medicine.
And you're responsible for oversight of the pharmacy? Yes.
Sorry.
I didn't mean to interrupt.
I hope you don't mind that we continued on without you? I said I was sorry.
There's no need to be sarcastic.
What is this? That's our prescription sign-out log from December 24th.
Does that appear to be Dr.
House's signature? Yes.
What has he signed for? A prescription for oxycodone in the name of patient Larry Zebalusky.
And did those pills ever reach that patient? No.
Why? He was already dead.
And Dr.
House knew this? Yes.
So, Dr.
House had no legal or medical basis for acquiring that oxycodone? Dr.
Cuddy? He never got the pills.
It's his signature.
The log is strictly controlled.
Dr.
House did pick up a prescription, but it wasn't for oxycodone.
It says oxycodone.
You testified I know, but it wasn't oxycodone.
Dr.
Wilson informed me that Dr.
House already tried to steal the pain medication of this patient, which made clear to me that Dr.
House was in a particularly vulnerable and desperate state.
So I went to the pharmacy and I swapped bottles.
Dr.
House only got a bottle with placebos.
I understand your impulse to protect a valued colleague I have it right here on the inventory report Your Honor, she's lying! She's obviously forged that report.
In light of this evidence If this is real, why didn't she mention it earlier? I move to dismiss this case! There is other evidence, Your Honor! Everyone shut up and sit down.
Dr.
Cuddy, why are you only now coming forward with this? I guess I never expected it to go this far.
The witness is excused.
Your Honor, you can't seriously believe Dr.
House, please stand.
My suspicion is your boss My suspicion is you have better friends than you deserve.
Rules and laws apply to everyone.
You are not as special as you think.
But Detective Tritter chose to make you so.
Detective, I don't know exactly what's going on here, but I am sure that this man is not flooding the streets with cocaine.
I'm also certain that, knowing Dr.
House, he must have done something to set you off.
But you're gonna have to live with it.
Given Dr.
Cuddy's testimony, I'm not going to allow this to proceed to jury.
Case dismissed.
Court is adjourned.
Dr.
House, you're still guilty of contempt for that little walkout earlier.
You'll be spending the night in jail, and after that you're going right back to your rehab.
Bailiff, take Dr.
House into custody.
Dr.
House.
So should I be looking for you in the shadows, or flinch every time a car backfires? Good luck.
I hope I'm wrong about you.
They got the meningioma.
Your brain should start generating real memories again.
What do I do when I get out? You have people who love you.
They'll take care of you.
You start over.
I'm surprised to see you're not spooning your way through the walls.
So, what do you say? How about a conjugal visit to celebrate? There's nothing to celebrate, House! You made me perjure myself.
Fabricate evidence.
You make everyone around you worse for being there.
The only bright spot is that now I own your ass.
When you get out of rehab, you're gonna be pulling double clinic duty, giving lectures to students, helping me find donors, pretty much anything else I ask.
You got it? Your buprenorphine.
You get these from the pharmacy or from Voldemort? Voldemort.
Why? What difference does it That's Vicodin.
He's been slipping you Vicodin? No! He'd be risking his minimum-wage job to do that.
The whole time? My higher power said it was okay.
Nothing's changed? Nothing's changed.
The apology.
You didn't need to do that to make this work.
Believe what you want.
Good night, House.
I'll see you tomorrow.
Good night, Wilson.