House, M.D. s03e15 Episode Script

I can't do this button.
You almost got it.
Almost got it.
The sound of the people talking Mmm? It's A-flat.
Is it? Well, look how smart you are, huh? Here we go.
Here we go.
Thank you.
I am proud to introduce my son to you, Patrick Obyedkov.
Twenty-five years ago, Patrick was in the fourth grade, a good student, played Little League and then there was the accident.
And here we are, raising money for people with similar neurological disabilities.
I hope you enjoy the concert.
You all set? All set.
He's never missed a note.
Something's wrong.
Patrick, what is it? My hand, it hurts.
Let me see it.
Oh, Papa.
What's the emergency? Thirty-five-year-old savant.
Dystonia in his left hand.
He paged us at 5:00 in the morning for that? I'm going back to bed.
Dystonia's not life threatening.
Clonazepam will take care of it.
He's already on clonazepam for seizures he has from a bus accident when he was 10.
Then we treat with benztropine.
What's up? Thirty-five-year-old savant.
Dystonia.
I'm going back to bed.
Where you going? Bathroom.
It can wait.
There is no case, House.
Even if dystonia was some big medical mystery, it's not this time.
You're not intrigued as to how a perfectly healthy 10-year-old boy with no prior musical training gets into an accident on his way to school and can suddenly play the piano? Do we have to solve a You two shower together? No.
No.
Double negative.
That's a yes.
Savantism is just one of those things.
It's inexplicable.
Just because it's inexplicted doesn't mean it's inexplicable.
I want new labs, CBC with platelets, chem panel, thyroid and adrenal function tests.
For what? I don't know.
Raise your left hand.
That's your right hand.
What are you looking for? Just want to make sure whatever happened doesn't happen again.
Push up.
Push up.
He repeats what people say.
It's a compensation mechanism.
He knows he's supposed to say something so he repeats what he's just heard.
Well, that's good.
Shows he's engaged.
Spine's okay.
All right, stick out your tongue like this.
Copy me.
You have a big tongue.
Hey, I know it's funny but copy me.
There was construction on Radcliffe.
So I had to get out of the car and walk in high heels for over a mile.
Radcliffe? What was the cross street? Does it matter? I don't know.
I'm not the one who brought it up.
Tie this off.
Nice and tight.
Does this have anything to do with my foot? You have a blister.
You don't waste a doctor's time with a blister.
You waste a doctor's time with more important things, like the sewer that's being vented out of your mouth.
My breath? If you could stop doing that, we'd all be grateful.
I can't stop breathing.
Nope.
But you can stop puking.
I don't.
Your lips say, "No.
" Your gnarly fingers say He's good to go.
It's a shame.
You look cute that thin.
Motor cortex looks good.
Everything checks out.
What tests did you run? Full battery of neurological I need this blood checked for cholesterol and glucose levels.
Patient had a foot problem.
Different patient.
There was no one else in there.
You're using the wrong equipment.
Dr.
Foreman, I thought we were being discharged.
I'm Dr.
House, and on the off chance that Dr.
Foreman didn't mention it, I have something of a gift, too.
Come on.
Your turn.
My turn.
Does this have anything to do with his hand? It might.
Okay, Patrick.
Close your eyes.
What's this? D, G-flat, A-flat, B.
Yeah.
All right, all right.
He's good.
Can we let him go? He's great.
He's staying.
Call radiology.
We need a functional MRI on his brain.
FMRI's not gonna show trauma.
We're not looking for trauma.
I want to see the music.
See the music.
Well, that's dull.
You think the FMRI's gonna show a big arrow pointing to a flashing sign saying "savantism"? It would be hugely helpful.
Somehow he got rewired as a music specialist.
I want to know how that happens.
He has access to parts of the brain that you don't.
His brain's doing nothing.
He looks like any jerk listening.
He's not a savant at listening, he's a savant at playing.
Well, listening and playing are two different neurological processes.
Turn off the music.
Patrick, I want you to pretend that your leg's a piano.
My leg's not a piano.
I know.
That's why I said "pretend.
" Kid's a moron.
Keep your head still.
Use your fingers.
Wow.
Cool, huh? His heart rate rose.
Emotional response? Then why's there no activity in the limbic system? Unless there's a problem with his heart.
Do an echo to confirm.
And scrub up.
He's gonna need surgery.
It wasn't dystonia.
He's got a heart condition that caused the arteries in his arm to constrict.
Do you have any idea why House would want to go to Boston? The chowder? Plane tickets this Friday.
I opened his mail.
I heard there's an opening at Harvard for Division Chief, Infectious Disease.
Ambition is not one of his more prominent traits.
Although What? He was testing blood in the clinic.
I don't think it was a patient's blood.
Why? It was green? No, he was checking for routine stuff.
Makes sense if he's looking for basic medical clearance for employment.
I'm going home.
No, you're not.
He could show up any minute.
Not with a savant to obsess about.
I'll take in here.
Bedroom's down the hall.
You've been here? Where else would the bedroom be? Come with? You're scared of him catching us breaking into his home but you're not scared of him catching us doing it in his bed? If I'm gonna get fired anyway Almost at the heart.
Ablating and done.
Heart rate's 160.
It's accelerating.
He's at 210! He's in supraventricular tachycardia.
Paddles! Charging.
Clear! We're wasting our time.
His high-school yearbook.
Unless you think he's going to Boston to attend a high-school reunion, put it back and let's get out of here before he comes home.
He's not smiling.
I wonder if he has teeth.
What's the area code for Boston? Massachusetts General.
May I help you? Did you think you could steal Dr.
House without a fight? Steal him for what? Quit jerking me around.
I know he's coming out there.
We're not looking to hire him.
He's called you six times in the last month.
We're not looking to hire him.
You think if you keep repeating it, I'll start believing you? Dr.
Cuddy, there's nothing else I can say.
I'm sorry.
If he's not coming there for a job interview, he's either coming to your hospital for a social visit or because he's a patient.
Is it a social visit, Dr.
Medak? I can't stand House.
Neither can Dr.
Coopersmith.
What's up? Do you know a Dr.
Coopersmith in Boston? Yeah.
He's an oncologist.
What's up? What's his subspecialty? Brain cancer.
What's going on? He doesn't look sick.
He should have symptoms.
Blurred vision, headaches, confusion, clumsiness.
Depends how far along the cancer is.
What kind, how aggressive.
He didn't tell you? House is House.
He's no different than anyone else with cancer.
Once you tell, then every conversation is about that.
Cardiac arrest means we were wrong.
There was a heart problem.
But no vasoconstriction.
The heart problem couldn't have caused the hand problem.
Unless the bleed happened suddenly.
Less blood to the brain explains the dystonia.
Less blood to the heart explains the heart attack.
Scope him above and below.
If that doesn't work, gut him.
Can't you sedate him? There's a risk his throat could collapse.
You look mad, Papa.
No.
No, I'm not mad.
I promise you.
It's just that the doctor has to do something to you and it's And it's gonna hurt.
Hurt me? Why hurt me? Make you better.
What's wrong with me? Well, they don't know.
Patrick, don't you worry.
Everything is gonna be great.
All right.
Here we go, Patrick.
You wanna hurt me.
Hey, open.
Like this.
You just look at me and everything is gonna be okay.
Look at me now.
Patrick.
There you are.
It's okay.
It's okay, really.
Dr.
Wilson.
Wilson! I just spoke to Cuddy.
She can't confirm whether House is applying for a job in Boston.
Yeah.
I'm late for a If I have to look for work, I have a right to know.
Pretty.
I wrote this when I was in junior high school.
Could never figure out what came next.
Then dimwit came up with this.
It's good.
It's perfect.
I could set up a tower on the roof during a lightning storm.
Help you switch brains with your patient.
Then you would be the brilliant pianist and he would be the doctor hiding brain cancer from his friend.
It's nothing.
You need to talk about it.
You need to talk about it.
At least let me look at your medical file.
You're making a big deal out of nothing.
Who else knows? No one, and cancer isn't nothing.
Sorry.
Didn't mean to offend your specialty.
Why didn't you come to me? Stein's good.
Stein's in Africa for the next six months.
He's given me at least six months.
I go to Boston.
I get the treatment.
Everything will be fine.
No need to talk about it.
You were right.
Surgeon found a bleed behind the kidney in the retroperitoneal cavity, but no reason for it.
No cancer, no ruptured arteries.
So bleeding explains the symptoms but we've got no explanation for the bleeding.
And while they were closing him up, Patrick had a grand mal seizure, which makes no sense, since he's on an anticonvulsant medication.
You told him.
No, I didn't.
I only told Cameron.
Hey! Okay, you guys have cleverly deduced that I have cancer.
You have no right to know.
You have no business knowing.
We'd like to run some blood tests.
As soon as you work up our patient, who is not me.
We just want to make sure you weren't misdiagnosed.
I wasn't.
Let's move on.
We're just asking for a couple of vials.
No! Why not? Okay, we are going to proceed as if I am perfectly healthy.
How can we do that if we know you're not? You don't know anything! Except, hopefully, how a patient on anticonvulsant medication has a seizure.
Anti-seizure meds don't prevent seizures.
They just make them manageable.
According to the surgeon's report, this one wasn't even close to manageable.
Means the question isn't, "Why is he having seizures?" It's, "Why are his seizures getting worse?" What's changed? His brain.
It's gotten worse.
So we make it even worser.
We take him off anticonvulsant medication.
He'll seize even more.
Multiple seizures can seriously damage a brain.
Dude can't button a shirt.
How much more damage are we really talking about? Stronger seizures will light up different parts of the brain, which will indicate which parts are damaged.
Once he gets worse, do a PET scan.
PET scan done? No.
Did you come for my feelings? 'Cause I left them in my other pants.
This is a letter of recommendation.
I'm applying for a job at Penn.
Thank you for writing your own.
I'm sure my thoughts are beautifully phrased.
Thank you for signing it, saves me having to fake your signature.
Stay away from Weiss.
He cries with his patients, holds their hands as they die.
He won't like you.
Your newfound nonchalance in the face of cancer.
I thought you'd find it appealing.
For what? The time it took you to go from hard-ass to human being.
You really want to leave? If you're not here, there's not much point in staying.
I'm not dead yet.
What are you doing? I know this must be a turn-on for you.
A little whorish to kiss and stab.
You kissed back.
I didn't want you to die without knowing the feeling.
Actually, no woman should die without knowing the feeling.
All we need is a few drops of your blood.
Foreman and Chase's lips are not gonna get so close, now that I know your plan.
There's a nurse downstairs about to risk his job to steal the blood you drew from yourself yesterday.
I'm patient number 020406, in the record room, under the name Luke N.
Laura.
There's a whole vial of blood in there along with CT scans, MRls, CSF.
Everything you need.
If you need a sperm sample, come back without the needle.
Six centimeter mass in his dorsal midbrain, extending into the temporal lobe.
That's inoperable.
What kind of time does he have? He's got a year.
Nurse! Nurse! Here's the consent from Boston for the cancer drug trial.
Any description of the process or previous trials? Yep.
Any chance it'll work? No.
It's not even designed to work.
Why would he It's designed to treat depression in terminal cancer patients.
He doesn't seem depressed.
Okay, let's assume that I am dying, which I specifically told you not to assume.
Can we at least assume that I'm not dying tomorrow? Whereas this kid PET revealed several more hot spots but they're non-specific.
How can you focus on him? It's the only way I can cope.
PET also showed a left brain that's working hard.
Harder than the right? Wouldn't be worth mentioning otherwise.
Bleeding in the brain, blood would irritate the lining, might cause the seizures to get worse.
Yes, he needs an angiogram to look at the vasculature inside his brain.
We'll get right on it as soon as we're finished here.
Don't get up.
I got it.
You're busy.
Continue.
You know what my team is doing right now? No.
They're trying to figure out what's wrong with me.
What's wrong with you? Thanks for asking.
They've found out that I'm dying.
That's sad.
Everyone's dying.
That's sad.
If a meteor lands on my head tomorrow, it's all academic.
I told them to leave me alone.
But did they? Did they? That one was rhetorical.
Oh.
No, they did not.
Who the hell were you before you hit your head? Hell is a bad word.
So is "ass" and "bitch.
" I could probably rattle off 50 much more complicated and disgusting ones, but then your dad would get pissed at me.
You like your life? What life? Your life.
Playing the piano, going on tour, scoring girls left and right.
I don't like girls.
Boys.
Whatever gets you off.
I like the piano.
What's wrong? Dr.
Peter Hayes.
This is Eric Foreman, at Princeton-Plainsboro.
You're doing a signal transduction inhibitor clinical trial.
What kind of results have you been Transduction inhibitors are a decade away.
Bye, Pete.
They've got another trial going at Duke.
beyond five years.
If you're positive for protein PHF Stop trying to save me.
I'm fine.
MRA confirmed small collections of blood throughout the white matter of Patrick's right hemisphere.
Mind if we chat about that for a few moments? Either trauma, an aneurysm, cancer or autoimmune disease.
We need a biopsy to figure out which it is.
His EEG was non-specific.
Where you going to biopsy? Everywhere.
Sure, just put on a blindfold and play "Pin the Tail on the Brain.
" He's bleeding into his brain.
He's dying.
You can't just randomly stab the temporal lobe and hope you hit the right spot.
I'm only gonna take little tiny pieces.
Till what? Till I find the problem.
Or you kill him.
No, I'll keep going, even if I kill him.
Then he's screwed.
Thanks for the chat.
What if we do the EEG from inside his brain? I'm actually a little insulted.
You were supposed to spend the last hour worrying about me.
It's risky and invasive.
But that's why God invented the long consent form.
Can you get to why this is a brilliant idea? External EEG could get confused if there are multiple structural abnormalities.
If we perform the EEG inside the skull, it could show us where to biopsy.
Brilliant.
Go.
Do.
I'd also like to talk to you about This is going to be personal, isn't it? Yeah.
We'll use a small drill to get inside his skull.
There's bleeding inside? Yes.
Once we have 12 holes, we'll surgically implant the electrodes under the meninges, against the brain.
And it's either cancer or autoimmune disease? Sorry, but yeah.
Which one is better? Neither.
Hey.
Where do we cut? We don't.
I need to say something.
Something personal? Yeah.
And I can't leave because you've got something interesting in that file.
Sorry.
You're an arrogant ass who makes it impossible for anyone to like him by punishing people who don't deserve Can you get to the "but" part of this speech? But I like you.
No, you don't.
You're just reacting to the perception of my death and the need to put things in order.
Fear of guilt Just shut up.
See? I annoy you.
Now, you gonna give me the results or are you gonna Intracranial EEG showed no electrical abnormalities.
Which means it's autoimmune.
No.
It also showed his entire right hemisphere is brain-dead.
So while you guys were worrying about me, half this kid's brain died.
The only solace you should take from this is the fact that it didn't.
Garden variety EEG sucks compared to the in-brain variety, but it's not going to miss brain death.
He's gotten worse.
Not that much worse.
Respiration is depressed.
Seizures are increasing, one every five minutes.
Not that much worse.
He can still talk and he's left-handed, which means speech is in the right side.
You don't know how Patrick's brain reorganized itself 25 years ago.
What if the right side is just a little dead? Maybe he still has random neurons firing.
You're just looking for a puzzle to distract you from your own situation.
You're right, he's dead.
Let's go home.
What did you find out? Is he gonna be okay? I'm sorry.
Yes! What's this? A piano.
What's this? He's obviously lost use Shut up.
Music is a global process.
You can't play the piano with half a brain.
What's it mean? Means the right side of his brain has always sucked.
Means it's not relevant to what's going on now.
Wow.
Then it's autoimmune.
Yeah.
Question is what do we do about it? Most likely ones we can fix.
Polyarteritis nodosa, Takayasu or Sarcoid.
I'll start treatment.
Not what I was talking about.
But, yeah, you do that.
Your turn? Do you have to do that? You mean cheapen everyone's attempt at a human moment by identifying the real calculations that go into it? Yeah.
Yeah, I do.
I'm sorry you're dying, I'm gonna hug you.
Anything to say? If you're considering grabbing my ass, don't start anything you can't finish.
Well, as long as we're just standing here, you mind if we work? How's the kid's treatment going? Are you crying? No.
Respiration rate's up.
Seizures are calming down.
It's all good.
Not for what I'm gonna do next.
There is no next.
He's gonna be fine.
Only if he wants to remain a four-year-old who wets his bed.
There's nothing else for him.
There's better.
Thanks for the hug.
It's the middle of the night.
You knew I'd be asleep.
Phone would have woken you up just as much.
And I can't see what you're wearing on the phone.
My patient with the 55 IQ has Takayasu syndrome.
Very uncommon.
Happens mostly in Asian women.
Takayasu is manageable with steroids, which you already know.
So I assume you're here for something else.
My patient also has a significant seizure problem.
Also manageable with anticonvulsant medication.
Yes, and if he kept taking his anticonvulsant medication, he could go back on tour and play the piano.
But a hemispherectomy would completely stop the right-brain seizure activity and he would no longer need to take his anticonvulsant medication.
You want to remove half his brain? The right half.
It would be irresponsible to remove the left.
You don't remove half a brain and gain function! Not my brain.
But his? Who knows? What? Let's say that I'm the left side of Patrick's brain.
I'm quick-witted, I'm charming, I'm great looking.
You're the right side of his brain.
You're useless, old, damaged.
We go to a bar for a drink.
Now, I have the mad skills to be scoring all the hot babes, but instead I'm spending my time wiping drool off your chin and making sure you don't eat the tablecloth.
What's the father want to do? I don't know.
So go wake him up.
House, I'm so sorry.
Forgot I was dying, huh? I'm here if you need me.
I need you.
One small feel for man, one giant ass for mankind.
Thanks.
Good luck in Boston.
Call the Make-A-Wish Foundation.
Dr.
Foreman was just here.
The seizures have almost completely gone away.
Says we might be able to go home in the next day or two.
Thank you so much.
I think we should remove the right side of your son's brain.
I thought you fixed him.
Does he look fixed? The right side of his brain is keeping him walking straight.
Other than that, it's been dead weight ever since the accident.
If we remove it, the seizures would stop completely.
The seizures are hardly noticeable.
They don't bother Patrick.
But without the seizures, the left side would have a chance to actually function.
It could learn to do new things.
Only bummer, he'd never play the piano again.
Oh, no.
The piano is everything.
I'm not saying he's never gonna work for NASA, but flipping burgers isn't out of the question.
Well, I don't mind taking care of him so he can play the piano.
No, you're actually lucky.
You don't have to watch your kid grow up.
You don't have to let go.
You trying to make this about me? I love my son, just the way he is! He's a monkey grinder at the circus.
He's worked hard to get where he So does the monkey.
The piano is a neurological accident.
He has a gift.
I'm offering him a life.
It's up to you.
I've isolated the cancer proteins in House's CSF.
About time.
We can't let him go to Boston if he qualifies for the Duke trial.
You want to do it? Damn.
He's negative for protein PHF.
He doesn't qualify.
What's that? That shouldn't be there.
Patrick? Hello, Papa.
Patrick, I have a question for you.
Yes? Are you happy? Are you happy? House! Open up! Open up! It's important! I've got a flight in three hours.
You don't have cancer.
There was an abnormal presence of IgG and IgM, indicating I don't have neurosyphilis.
My MRI showed nothing It's a gumma in your brain.
It's very rare not to be in the liver, and I'm really glad we never slept together but We would have used a condom.
And I don't have syphilis.
My VDRL was negative We did an FTA antibody test.
The VDRL was a false negative.
You're not going to die.
All you need is IV antibiotics.
Did you send these results to Mass General? Of course.
You idiots.
We just told you you're not gonna die! You should be making out with Cameron.
You knew it wasn't cancer? I was sure it was cancer.
Then why aren't you celebrating? Because it wasn't my damn file.
You faked cancer? The real patient is in the Witherspoon wing.
Feel free to tell his wife that he's not gonna die but he is cheating on her.
Why would you want us to think that you I didn't! I wanted the guys in Boston to think that I had cancer.
I wanted the guys who were gonna implant a cool drug right into the pleasure center of my brain to think that I had cancer! You faked cancer to get high? I'm going to bed.
You're right.
I don't like you.
Sure.
Now that I'm not dying.
Heard Patrick's hemispherectomy went well.
He survived the surgery.
He's unconscious but How depressed are you? I'm not depressed.
You faked cancer.
It was an outpatient procedure.
I was curious.
Are you curious about heroin? Not since last year's Christmas party.
I know this goes against your nature, but can we not make too much of this? You made people think that you were going to die! I didn't make them.
I tried to hide it, but you idiots needed to get into my business.
I'm sure I'll regret asking, but why are you laughing? It's ironic.
Well, I'm sure I'll regret asking, but why Depression in cancer patients It's not as common as you think.
It's not the dying that gets to people.
It's the dying alone.
The patients with family, with friends, they tend to do okay.
You don't have cancer.
You do have people who give a damn.
So what do you do? You fake the cancer, then push the people who care away.
Because they're boring.
Go home to your hotel room and laugh at that irony.
Start small, House.
Take a chance.
Maybe something that doesn't involve sticking stuff in your brain.
Pizza with a friend.
A movie.
Something.
Follow my finger.
Do you know your name? His speech center was on the right side.
It'll be a while before he's talking.
He hasn't really done anything except to stare off into the distance.
It'll take some time to You buttoned your shirt.
He looks happy.