House, M.D. s03e24 Episode Script

Coming up to 50 feet.
Roger that.
We're light on fuel.
Two minutes to bingo.
Come on, Fisher, we got places to go, people to see.
Working on it! So I've heard.
What's taking so long? SOWINSKl: Let go of the suitcase! Let go of the suitcase! You're gonna have to hold on to me! Sir, whatever it is, it's not worth it! We're at bingo fuel, sir.
You hear that, Fisher? Bingo! Either reel him in or we're leaving them both here! Okay, sir.
Ditch the damn luggage! Marina.
Marina! Marina! Tell him if he was so worried about his wife's clothes, he should have stayed in Cuba! He says it wasn't her clothes, it was her medical records.
Says she's sick and needs to go home.
No home, House! I need to see Dr.
House! You don't answer your phone anymore.
I'm world-famous now.
Press won't leave me alone.
It's Cuddy.
I know.
If it was the press, I'd be answering.
And since you're not taking her calls, I am.
Your patient's been waiting for hours.
She didn't book an appointment.
No, she risked her life.
If you don't reach terra firma, you don't get any milk or honey.
The woman has 10 different things wrong with her, including pains all over her body.
Admittedly, not as interesting as staring uselessly at Foreman.
You know why I find a goodbye party fascinating? I think it's kind of insulting to celebrate when someone leaves you.
What are you gonna do to keep him? Nothing.
He really is gonna leave.
You know that, right? Yeah.
So what are you gonna do? Nothing I can do.
He doesn't want more money, better working conditions, doesn't even want a better job.
He wants to not be me.
Because he thinks you're a cold-hearted bastard without any regard for anyone but yourself.
He's right.
You need to show him that you really do care.
Don't! Foreman's not the only chocolate-covered cherry in the box.
House, you play a guitar you got in ninth grade.
Eighth.
You're living in the same apartment for 15 years, you drive a 10 year-old car, you are not good with change.
That used to be true, but I changed.
He's not afraid to be you, he's afraid to be who he thinks you are.
Rheumatic fever would explain the skin rash.
But not the double vision or bloody urine.
They were lost at sea for three days.
Severe dehydration causes kidney problems.
And the double vision? Concussion during the shipwreck.
It all fits as long as each symptom started when you think it started.
This would be a lot easier if we had her medical records.
Any of you certified deep-sea divers? She's from a dirt-poor country in the tropics.
Infectious disease and parasites are the most likely cause of unexplained pain, fever and skin rash.
We might as well start there.
If there's one thing Castro knows, it's how to look great in green.
And if there are two things Castro knows, it's how to look great in green and train doctors.
Even without the medical records, we can assume she was drowned in antibiotics before she risked drowning to see me.
So what doesn't Castro know? How to lay his hands on high-tech scanning equipment.
Pain, double vision point us toward the head.
Cameron, get an MRI.
See what's cooking in the old cabeza.
Chase, check out the husband.
Why? He hasn't complained of any pain.
Basic math.
Take all of her symptoms, subtract his sea symptoms, the remainder equals her original symptoms.
Are you in any pain? No, I'm just sunburned.
Any blurred vision? No.
So my wife, she is with Dr.
House? She's with another doctor who is part of Dr.
House's team.
No, she's supposed to see Dr.
House.
We have permission.
That's the way it works with Dr.
House.
I came 1,000 miles to see him! He doesn't care.
I'm sorry, but that's who he is, that's who you risked your life to see.
And you made the right choice.
Any other metal? Must have been difficult on the boat.
When the storm came, yes, very much.
I pray while my husband, he With the paddles? You were on a boat without a motor? No, no, we start with a motor, but it break on the first night.
My husband, he can fix anything.
A washing machine, a car, a computer.
But that is stupid motor.
And me.
These two he cannot fix.
He got you to us.
He never gave up.
No matter what happen, he kept saying to me, "Don't worry, "we will make it.
"I'll take care of you.
" That's Esteban.
He refuses to worry or pray.
He believe if you don't have one, that you don't need the other.
Husband has a pulled muscle in his shoulder, but no other pains or double vision.
He does have a fever, fungal rash, cough, and elevated bilirubin.
Foreman's not going anywhere.
He said that to you? He doesn't really wanna leave.
And you don't really wanna let him.
You'll cave, just like you did with Cameron.
Foreman's not as easy as Cameron.
But, of course, who is? I'm in the room.
He may not want a date, but he does want something.
Well, maybe it's something I can't offer.
Then you'll just lie.
He'd see through it.
Maybe.
Or maybe he'll just see what he wants to see.
She has MS.
Explains the pain, fatigue, double vision, kidney problems.
The kidney problems aren't connected.
Her husband has the same issues.
It is possible for two people to have the same symptom for two different reasons.
If we're gonna take that approach, then we may as well just throw out everything we got from the husband and start over.
We could do that, or we could do something productive.
Start her on Interferon for the MS, see if she improves.
I do like being productive.
Well done.
Do it.
"Well done"? Is that what you think he wants, a pat on the head? Go do your job.
She does not have MS.
I know it's not a pleasant diagnosis to hear But, no! The doctors in Cuba would have found MS.
What's that? It's all right.
Her pulse ox just came off.
Marina, you can't But it hurts.
Her pain is getting worse! Your treatment isn't working because it's not MS.
Does this hurt? Wow! Well, either Foreman's way stronger than he thinks he is or Seriously.
Or? She's too young for osteoporosis that severe.
And too old for osteogenesis imperfecta.
Which leaves bone cancer.
Cancer's a long shot.
Why? Because metastatic tumors don't explain the abnormal MRI, kidney damage, cotton mouth, double vision.
Oh, wait, they do! Infection could do all that, too.
It's not an infection.
Because you know the nonexistent medical records confirm that the brilliant doctors in Cuba treated her for infection, or because you're trying to kiss up to Foreman? Because an infection would cause a fever, and the brilliant doctors who work in my office have already crossed that off the list because the husband You're the one who said it's possible for two people to have the same symptom for two different reasons.
And you're the one who said if we do that, we might as well throw out everything we got from the husband.
Right, and then you said we should do something productive like breaking her arm? Foreman didn't break her arm.
Of course he didn't.
Cancer did.
Put her in a PET scan, see what else it's breaking.
This isn't gonna work! He's not a moron! You can't just agree with everything he says for two days and hope he forgets the last three years and how much he hates you! Anything else? When you get the results of the PET scan, let me know.
I don't really care if Foreman stays or goes, but You're fired.
What, because I yelled at you? Because you've been here the longest, learned all you can or you haven't learned anything at all.
Either way, it's time for a change.
Fine.
No tumors in her arm.
Synovial membrane is working fine.
No hot spots, no bone cancer.
Maybe we should be looking for something else.
Is it raining out? House fired me.
What? Because you yelled at him? "Time for a change" was the official explanation.
It makes no sense.
Since when does House make sense? He always makes sense.
He's angry.
Yes, it's all about you, Foreman.
He's upset you're leaving, so he fires Chase.
Excuse me.
On the humerus, she's got a hot spot.
Why'd you fire Chase? Sure thing.
First you tell me the results of the PET scan.
Did you fire him for me? Would you stay if I did? You asked him to fire Chase? No! Yes! You're frustrated with Foreman so you lash out, kick the dog? He's not gone five minutes and the name-calling starts.
What's on the PET scan? Why'd you fire Chase? Do you know what's on the PET scan? You two, out.
Wait! What's on the PET scan? You can't dump your entire department just because you don't know how to deal with an issue.
Yes, they are all irreplaceable.
If only in this country we'd figure out a way to somehow teach people to interpret PET scans.
What the hell's wrong with you? You fired Chase? I don't suppose you know what's on my patient's PET scan.
I told you to show Foreman you have a heart.
How does that translate into you being a bastard? So that's a no.
Pick up the phone and tell Chase you made a mistake.
Un-fire him.
Chase, if you know what's on the PET scan, call me back.
Cut the crap.
Chase is a good doctor.
Sorry, you're in the wrong room.
My name on the door, my team, my decisions.
My building, my floor, my people.
Hold that reprimand.
House.
Dr.
Chase! How are you? Thank you.
You are indispensable.
You're still fired.
Sorry.
Wow, that was awkward.
PET scan revealed a blood clot in my patient's arm.
Which means goodbye.
Still got two people working for me, gotta get one of them to do my job.
A clot means a heart problem.
We have to do an emergency angiogram.
But you're not sure it's a blood clot? PET scan can't determine that with certainty.
So you have no better idea what's wrong with her than when we first got here? We've ruled out MS.
I told you it wasn't MS.
Where is Dr.
House? Dr.
House has left for the night.
He'll be here in the morning to review the results, if you sign the consent.
But, you know, you could call him at home.
He doesn't always pick up, so keep calling.
Thank you.
Dr.
House, it's Esteban Hernandez again.
As soon as you get home, it's very important you call me.
Hello, yes, Dr.
House, it's Esteban Hernandez.
As soon as you get home, if can you please call me? The catheter is in her femoral artery.
Why are you telling me that? Because you're assisting.
Do I look like I'm assisting? I had nothing to do with Chase's termination.
Is everything okay? You're doing fine, Marina.
The dye will take a minute to work its way through your system.
Why would you tell House you're leaving because he's a jerk? Because it's the truth.
Did you give an angry Cuban my home number? Why would you do that? You're not turning into House, you're worse than him.
Let me get this straight.
Instead of picking up the phone and talking to a patient for five minutes, you gave up on sleep and drove in here.
My chest! She's in V-Tach.
What did you do? Nothing! Must have hit something.
You nick an artery? She has no pulse.
It hurts.
She has no pulse, but she's talking.
Cough! Cough again! Keep coughing! It'll push blood into your head, keep you conscious.
Push one milligram Epinephrine.
Will that help? No.
But it is amazingly cool.
We need to get her on bypass! We need to keep her here.
If this was a clot, the force of bypass will blow it into her brain, kill her.
If we continue CPR, she'll lose blood flow, which will cause brain damage.
What caused the heart to stop? Let's assume it wasn't human error.
I didn't nick an artery, it just stopped.
I said let's assume.
The only other option is electrical instability.
No ST segment changes.
We need to tell the husband.
Tell him what? We have no idea what happened.
House? Keep going until I figure this out.
House! Jeez.
At 47, I hope my colon looks better than this guy's.
Isolating the first transverse Help! I'm trapped inside a monitor! Not a good time, House.
My patient lost her heartbeat during routine cardiac catheterization, so Human error.
It's not human error.
Electrical instability? Pre-procedure EKG was normal, no syncope.
Ischemia? Foreman said no ST segment changes.
Human error is the only other possible It's not human error.
Of course it's human error! You don't want Foreman to have made a mistake because then you'd have to mock him.
And that would put a crimp in your brilliant plan of keeping him by having a breakdown and firing Chase.
Did you just spit on the monitor? You know I can't see you.
Human error would not explain her symptoms.
You mean her heart stopping? I mean her foot pain, her back pain.
House! I'm busy! You have a team, run your differential with them.
Foreman and Cameron are doing CPR.
Then you shouldn't have fired Chase.
Change is fun, huh? Five, six, seven, eight! Go! Someone's gotta talk to the husband.
He thought this whole thing was gonna last 45 minutes! A half hour more of this, nothing to talk about, we won't be able to bring her back.
We gotta get her on bypass.
House still isn't answering his phone.
You, get in here.
Go! Excuse me, my wife was supposed to be back an hour ago As soon as we know anything, we'll call you.
Thank you.
Human Behavior finals will also get into clinical presentations of mania, and we'll touch on Stanislas Dehaene's PET scans.
Excuse me, Professor.
House, when we're done with our rounds My patient has no heartbeat.
Stopped when we inserted a catheter during a routine angiogram.
Anyone tells me why her heart stopped gets an A in Dr.
Cuddy's class.
Anyone? Human error? Yeah.
I'm polling first-year medical students because I hadn't considered human error.
Marfan's Syndrome? Structural abnormalities would show up on the echo.
You get a C.
Yeah? Botox injections.
F.
If the injection was tainted with live botulism, it'd fit.
B- plus.
Unfortunately, she missed her last Botox appointment due to a boating accident, but send me your résumé.
House, time's up.
Good Lord, you smell like musk ox.
Either our patient goes on bypass, or I call time of death.
Your patient isn't already on bypass? I was worried about a clot.
How long? Three hours.
House.
Bypass, now! Clear the hall! Out of the way, please! Let's go! Excuse us! Dr.
Foreman! My wife! What has happened? Her heart stopped.
We have to get her on bypass.
He needs to wait outside.
Got it? Dr.
House.
You can vacuum later.
I am not the janitor, I am Esteban Hernandez.
What happened to my wife? Her heart stopped.
Why did her heart stop? Well, if I knew that, I'd be coming to you.
Tell me where you take her.
Tell me what is happen to her? "Happening.
" It's a present participle.
Not a particularly interesting form of speech.
Kind of like this conversation.
But I risk my life to see you.
I looked you up.
You fix people.
When everyone else gives up, you don't! And now you insult me? Ignore my wife? Helps my process.
You do not ignore my wife, okay? She is everything to me.
Well, then you do not ignore your wife.
You just sit here! You don't talk to people.
How do you fix something if you don't look at it? Turn on bypass, please.
Good.
Good distal flow.
Need to look at the heart.
Why? I can't find my wallet.
Pick it up.
Turn it over.
I don't see anything physically wrong with her heart.
Hearts don't stop for no reason.
Okay.
Take your look.
You see anything wrong? Give her a jump-start.
Clear.
Clear.
Clear.
And again.
Clear! Clear! Clear! Again.
Yeah, seventh time is the charm.
Sorry.
I'll keep her on bypass until the husband has a chance to say goodbye.
I'm not telling the husband anything until I can tell him why his It doesn't matter.
Her heart can't start.
She's dead.
I got you something.
I'll miss you.
I know you won't miss me, but I just thought it would be nice for you to have that.
I will miss you.
Can I have a hug, too? The surgeon found nothing.
He can't start her heart.
What a thoughtful gift.
Nice reminder of intellectual theft to hang at your new place of employment.
You two can go.
Say hi to Chase for me.
You're wearing lipstick.
We can stay.
We can run another differential.
You two have no theories about why the heart stopped, which means I don't need you.
Go.
It's too late for theories.
We need to tell the husband.
Tell him what? That it's over.
Why? Because her heart won't start! How can we tell him there's no hope if we don't know why there's no hope? He's not gonna pull the plug on his wife.
He risked his life to get her to me.
If he pulls the plug, it means he's failed.
If he pulls the plug, it means you've failed.
And you're okay with that? Go.
Hey.
Hey.
You look great.
You know House firing you has nothing to do with you.
The why doesn't matter.
Foreman will end up staying, House will call you, probably yell at you for not showing up.
It's okay.
He's right.
It's time for a change.
You were right, too.
The whole "It's Tuesday, I like you.
" It was silly.
Oh, don't give me that look.
Don't feel sorry for me.
Getting this job was the best thing that has ever happened to me.
Everything about it.
And losing it? Well, I think it's gonna be good, too.
I'll miss you.
Have you got time for a drink or something? I think I should go.
Yeah.
How's it going? The way the security light hits your legs, looks good.
Thank you.
If you're here to yell at me about the Foreman-Chase situation, it can wait.
When do you plan on telling the husband it's time to say goodbye to his wife? Haven't put a clock on it.
Other than your curiosity, do you have any reason to keep her on bypass? Patient's husband prefers her not dead.
Or you want a storybook ending for the young man who crossed the ocean for his wife.
This is not an act.
I don't care.
Then pull the plug! What if I can fix it, but I just don't know it yet? I know you care.
I don't care! I really don't care.
My motives are pure.
If we do an autopsy and we see, "Oops, "if I'd thought of that crazy idea, we could have saved her," then the husband might be upset.
You've done all you can do.
It's time to let go.
I was told you didn't believe in God.
I don't.
I promise my wife I'll do everything I can to fix her.
If I don't pray, then I don't do everything.
It's not working.
She's not coming back.
If you want to say goodbye, you can come down to the ICU, and then I'll take her off bypass.
I'm sorry.
I should have Marina, I am so sorry.
When you turn the machine off, that's it? Yeah.
Right now, is her brain working? Probably.
Just not her heart.
She seems like she's just sleeping.
She's not sleeping.
We double-checked.
Her heart? It beat? No, it's residual flow from the bypass.
No, I can feel it.
Look! That is her heart, no? P wave, Q, R, S, T wave.
That's a normal normal.
Esteban? Marina! Holy crap.
Is this heaven? No, it's New Jersey.
God sent you back to me.
It's a miracle.
It's impossible.
Apparently not.
Live hearts don't stop for no reason.
Dead hearts don't start for no reason.
Apparently they do.
She's three hours off bypass and still stable.
And the pain is gone.
No, it's not.
You think she's lying about feeling better? Just because it's not there now doesn't mean it's gone.
Just because it was there before doesn't mean it's coming back.
Chase was probably right.
She had some sort of tropical infection that cleared when we put her on antibiotics during the bypass.
Antibiotics did not bring her back to life.
Other than a miracle, it's the only explanation for her symptoms.
How come God gets credit whenever something good happens? Where was he when her heart stopped? What if it wasn't human error? What if it was God's error? A congenital defect in an artery making it susceptible to inflammation.
We need to do another angiogram.
We've looked at her heart 100 different ways.
There was no evidence The one time we looked inside her heart, we stopped before we could see anything.
Because it stopped.
Good news.
I think we know what the problem is.
You mean "was.
" Hey, it's my first language, not yours.
If she wants to outlive Castro, we need to fix her heart.
In case no one's filled you in, today is Monday, which means you've been dead for a day.
If that kind of symptom comes back, it can get serious.
I need to do another angiogram.
Wait.
Wasn't that what caused her heart to stop before? No, God caused that.
He's all-powerful, you know.
He was watching over us in the ocean and he's watching over us now.
Your rescuers didn't have wings, they had a helicopter.
Esteban prayed.
Do you know how many little boys are praying for jetpacks? How many priests are praying for Well, that one actually works.
You didn't bring me back to him.
And I'm not gonna take you away from him, but if we don't do this test, God will.
You said there was no chance, no hope, which means Which means I was wrong.
But I'm wrong all the time.
My mistakes don't prove there's a God.
You came a long way to see me.
You gonna put her life in God's hands or in mine? Ready? I better not see you praying.
I don't want to have to fight for credit on this.
Exiting the femoral, entering the aortic arch.
This is where Where we stopped to have a picnic last week.
Her blood pressure's rising! Mine's rising, too.
Of course, I am doing battle with a deity.
In the heart.
Injecting the dye.
Right coronary flow is unobstructed.
Left coronary flow looks normal.
Looks like you're wrong.
Either I'm right or this test is about to go very bad.
What's that? She has one, two, a third ostium! How many is she supposed to have? Dos.
All the third one's doing is causing inflammation, throwing off clots, getting in the way of the angiogram.
No human would screw up that big.
Don't worry.
Just one more surgery, it'll be fine.
Thank God! Don't make me slap you! Hi.
It's Tuesday.
No, it's Monday.
I know, I just I didn't feel like waiting.
I hear you got another satisfied customer.
One more and I get a set of steak knives.
Well, this is it.
I appreciate the opportunity you gave me.
Didn't do it for you.
Thought you were the best guy for the job.
Thanks, I guess.
Which is why I want you to stay.
You're an important part of the team.
I need you.
I know.
But I don't need you.
And I definitely don't wanna be you.
You're miserable.
I just solved a case by predicting a never-before-seen heart defect.
A case you couldn't solve.
A case you gave up on.
I couldn't be happier.
For two minutes, maybe.
Until the next case comes along.
Until you're jonesing for your next fix.
This woman talks while in full cardiac arrest and you're more excited about the talking than the heart dying! The two were connected.
I don't wanna solve cases.
I wanna save lives.
Do you think she cares? Do you think the husband cares? You think the children she can now have because of me are gonna care why I saved her? I care.
About yourself! About your own ego! House.
You're the selfish bastard, not me, which is why you took so much pleasure in drawing out this little goodbye of yours for the last three weeks.
It wasn't for me, it wasn't for anyone! It sure as hell didn't help anyone! Nice try.
Nice tries are worthless.
You now have a bigger office than I do.
Why don't you go enjoy it? Better be naked pictures.
My resignation letter.
I've gotten all I can from this job.
What do you expect me to do? Break down and apologize? Beg Chase to come back? No.
I expect you to do what you always do.
I expect you to make a joke and go on.
I expect you to be just fine.
I'll miss you.
Genuine American cigars.
You guys can't get them in Cuba.
Shouldn't you go home? Patient follow-up.
Very important.
She looks great.
I think she's sleeping.
She is sleeping, I double-check.
So, they all quit? Two of them quit.
I fired the third.
It must be very hard to lose your people.
You must be very upset.
Yeah, I must be.
But you're not? I don't think I am.
I think I'm okay.
What are you going to do? God only knows.