House, M.D. s04e15 Episode Script

You like that? I don't know.
You want me to use my butt again? I don't know how I got here.
How many drinks did I have? Your scotch hasn't even arrived yet.
Means I was drunk when I got here.
I remember being at work.
I've lost at least four hours.
Say five words.
What do you mean? That's four words.
The accepted diagnostic test for global memory impairment is five random words.
Are you okay? I'm trying to find that out.
Now, give me five animals.
Cat.
Bird.
Monkey.
Rhino.
Goldfish.
Monkey.
Rhino Either I'm massively drunk You're bleeding.
Or it's someone else's blood.
Can you see a wound? How bad is it? It's all over.
I have concussion.
Retrograde amnesia.
No keys, no phone, I've been mugged.
No, you haven't.
You already gave me a twenty.
Did you earn it? Not yet.
Someone is going to die.
Kenny! Not you.
I saw something.
A symptom.
Someone is going to die unless I find them.
Who? I have no idea.
Keep the change.
I saw somebody dying.
You saw 30 people flying into glass and metal.
I saw a symptom before the crash.
You're concussed.
You don't know what you saw and you don't know when you saw it.
A week ago, you noticed a symptom in a soap star.
Bad argument, since I was right about that.
But your brain obviously thinks it happened last night.
Wires are crossed.
That's all of it.
A few stitches will hold your brain in place.
Ow! Hey, hold your head still unless you want me to sew your nose onto your eye.
Why was I taking a bus? Because you were drunk.
What if I saw someone and I followed them on from somewhere in Princeton? You okay? Perfect.
Uh You.
Get histories from everyone in here.
Did you just forget his name? No.
Lesbian, find out if anybody on that bus was taken to other hospitals.
You just forgot mine.
No, Thirteen.
I just wanted to call you a lesbian.
I'm not a lesbian.
I was rounding up from 50 percent.
Find my cane and motorcycle.
Figure out where I went last night.
Where's your cane and motorcycle, and where'd you go last night? You're gonna trust me? I lie about everything.
You're staying the night.
We need to monitor your brain for swelling.
How much bigger could it get? You don't think it's a little weird that there's both a giant crash and a simultaneous, mysterious symptom sighting? What if it's not a coincidence? You mean like the hand of God reaching down and screwing with you? That, or the symptom caused the crash.
You see anybody in a bus driver's uniform? Right here, purpura on Lalph Klamden's neck.
Indicative of leukemia.
It caused a bleed in the brain, hence the accident.
Indicative of wearing a seatbelt.
It's just a bruise.
I have leukemia? No, we just ruled that out.
Pay attention.
So he probably had a seizure.
I didn't have a seizure.
I got hit by a garbage truck.
Which you drove into while you were seizing.
You saw the bus driver exhibiting the initial stages of a seizure and didn't bother telling him to pull over? Hey! Nobody leaves here until I say they can be discharged.
She said I was Is she me? You have a fever.
No, I'm fine.
I need him to stay.
Pulse is normal, BP's normal, everything's normal.
I just have a stiff neck from the crash.
Stiff neck.
This man has meningitis.
We need to quarantine the whole ER.
No one leaves here until their full work-up is complete.
You left here at 5:23 p.
m.
Your motorcycle never made it home.
Well, that covers ten seconds out of the four hours I can't remember.
Where else did you look? We did pull up a list of all the injuries.
Twenty-two victims were brought here, injuries ranging from a broken pelvis to a severed right foot.
The other eight were taken over to Princeton General.
Be helpful if these came with head shots and resumes.
Twenty-something-year-old Jane Doe, kidney contusion, laceration on her leg.
Both of which are expected complications when someone goes from 60 to 0 in no seconds flat.
Weirdest thing we've got is a ruptured spleen.
Okay, new plan.
We make a list of all the bars between here and the crash site, we find out where I went, we go there On it.
You're not gonna do anything, are you? We're gonna go to the ER and do our jobs.
Someone's dying because I can't remember When you remember, you can page us.
The shortest distance between here and your memory is straight through your pre-frontal cortex.
All we have to do is access it.
Great idea.
I'll build the giant submarine, you get the miniaturization gizmo.
Medical hypnosis can bring the brain to a Class 2 Theta state, increasing focus and memory retrieval.
You're not gonna make me do the chicken dance, are you? Someone in the surgical department must be trained.
Just relax.
Keep letting go of any intrusive thoughts.
So what? You saw an ad on the back of a comic book? I did a rotation in Melbourne.
Focus on the sound of your breath.
You're taxing an already injured brain.
It's like telling him to walk it off after a broken ankle.
Wilson is done talking now.
Visualize the bus.
The way it looked.
The way it smelled.
The people on it.
What they look like.
This is a waste of time.
Cool.
Focus on the details.
The bus is empty.
Is this really working? Just focus.
Clear your mind.
Think back to how you felt.
Details you saw.
I can't see out the windows.
And I can see you guys.
Memories further from the incident should be clearer.
Where were you before you got on the bus? Why'd you get so drunk at I need a reason? God, I hate "Beer" brand beer.
When he's hypnotized, can he lie? He I could be mistaken, but I can't actually lie under hypnosis.
Is he lying? No.
What are you running away from? When I'm drinking, without you, what am I running away from? One of those imponderables.
Can we hold off on your insecurities until we find this patient? Do you see anyone in the bar? I see a faceless crowd.
How do I focus? Say something to make me focus.
He's concerned about you.
Why does that mean he's insecure? Get your girlfriend out of here.
It's a legit question.
Amber's there? You've got Amber in your head? You put her in my head.
I can't even have a conversation with you in my subconscious without her tagging along.
She'd better have her clothes on.
Unfortunately.
I didn't mean to say that out loud.
Say what out loud? I didn't say it out loud? Nothing.
What's going on in there? If I can't lie, I need these two out of here.
Let's just ignore Wilson and Amber from now on, shall we? I wish it were that That's some program they've got down there in Melbourne.
Cheers.
I remember the bartender.
Good.
Now you're accessing your temporal lobe.
Does the bartender have any odd symptoms? No, he seems fine.
Is anybody here sick? Anyone here taking the bus? You are.
Because you took my keys.
Good.
This is good.
Now we can retrace your steps.
Let's go back to the bus.
What's in front of you? Passengers.
Anything special about them? Some Emo guitar hero wannabe.
You're focusing on him.
Why? Because nose picking could mean nasal pruritus.
He's dying.
You a nose picker? Do I have to answer If the answer was no, you would have answered.
Tilt your head back.
He's fine.
Doesn't even have meningitis.
Just like everybody else we've had to give meningitis shots to.
You can go.
You have a brain tumor.
You're kidding, right? If I was kidding, I'd be dressed like you.
You're fine.
A nurse will sign you out.
Go home, have fun, relax.
I'm probably just a nut case.
Tilt your head back.
Get your things and go.
You need to rest.
I'm admitting you.
I can't get up! I can't move my legs! Your legs are not your biggest problem.
Your biggest problem is I don't know what your biggest problem is.
So, we have the who but not the what.
We've only got one symptom to go on.
Sudden onset paralysis.
We actually have two symptoms.
Only one that we remember.
You did a full work-up on the guy.
Did you find anything? CT ruled out subdural hematoma, stroke, or subarachnoid hemorrhage.
Guillain-Barré fits.
Just trying to figure out what Guillain-Barré looks like.
You can't just eliminate everything because it doesn't match what you might have seen.
How about because it doesn't match what I could have seen? Guillain-Barré has no external physical manifestations.
Everything has some external physical manifestations.
And you're obsessive enough to notice any of them.
Which means there's nothing we can rule out.
Elevated white count.
Means transverse myelitis Sudden paralysis while driving a bus.
That's the sort of subtle clue that only a genius would have noticed.
Are you sure you're feeling okay? Where are you going? To smell a bus.
Obviously.
Yeah, I'll start him on antibiotics in case it's transverse myelitis.
You guys go sniff a city bus.
Why are you smelling the passengers' clothes? Smell is the most powerful evokerater of memory.
I need to get back on that bus.
Okay.
So why are you taking so much Vicodin? If Cuddy asks, blocking the pain helps focus the memory.
You split your head open.
You should rest.
Anything? Hint of exploded bus.
House, that's four Vicodin in forty seconds.
At this rate Wish me luck.
I'm going in, Rambo style.
House, do you think this is gonna work, or are you just stoned? Both, apparently.
You're wrong.
It's not working.
So you're saying I'm not here? If it was a real memory, you'd be limping and you wouldn't be talking to me.
I'm obviously a hallucination.
Okay, so I went a little heavy on the Vicodin.
Better hope so.
'Cause otherwise, means your brain's bleeding.
We're both in my head.
You'd think one of us would have noticed the blood.
Why haven't you had a head CT yet? Who do you want me to treat? Me or you? Did you have a seizure? Dumb question.
The brain's too fried during a seizure to form memories.
Dumb answer.
I wasn't asking you, I was asking me, because you've already proven that you're not here.
I'm getting a headache.
Is that a clue? Again, I'm not here.
You're getting a headache.
Stop arguing with a hallucination and get some treatment.
He can't.
The hallucination is your messed-up brain's way of reasoning out a problem.
You weren't on the bus.
How do you know? Five-hundred-dollar shoes? Not on the Princeton cross-town.
Must be another reason why I'm here.
Yes.
What do you have to tell me? I was talking to the passengers on the bus.
You were hallucinating.
You're getting an MRI.
Stop fidgeting.
If you haven't found the bleed yet, it can't be There's edema and localized swelling in the section of the temporal lobe that controls short-term memory.
Also, the penis size cortex is set to "pathetic.
" What didn't you say out loud? Very little.
When you were under hypnosis, you were talking to Amber.
I wanted to see her naked.
Seriously, what were you hiding? I want to see her naked.
You want to see everyone naked.
Why would you hide that? Some guys get upset when you objectify their girlfriends.
But if you're okay, I got a digital video camera, so we could Why would I be upset that you're treating my girlfriend like you treat every other woman on the planet? Unless you're not.
Unless it's deeper than that.
You weren't objectifying her.
Trust me, I want to do some very nasty, demeaning stuff to your girlfriend.
You have feelings for her.
This is bad.
It's a longitudinal fracture of the temporal bone.
I banged my head.
This isn't just a boo-boo.
I'll rest once I figure out what's wrong with this guy.
Why? Why this guy? You want patients with weird, undiagnosed symptoms? You get five files like that on your desk every morning.
And you'd never risk your life for them.
Why is this guy so special that all of a sudden you've become Batman? I don't know.
Maybe it's because you have a cracked skull and you're not yourself.
Go home, go to sleep.
My legs are holding.
Good.
Now put all your weight on your right leg.
The antibiotics are working.
It's TM.
It's 2:00 in the morning.
You should be home resting what's left of your bruised brain.
Recovery's too fast.
What, the fact that he's getting better is evidence that we're wrong? I need to sit.
Recovery slow enough for you now? It's my stomach.
Which means it's not tranverse myelitis.
Rapid onset, could be a perforated ulcer.
Wouldn't explain the paralysis.
Addison's.
From a tumor.
It's possible that I saw his eyelids droop.
We've scanned his head five times.
You're bleeding.
Little thing called a bus crash.
Just a scalp laceration.
It could be hidden in his optic chiasm.
It's coming from your ear.
Think that's a good thing? But that would have affected his eyesight.
I need to take a bath.
Hallucinations and smells were kind of working, right? Why the bath? Hypnosis gave me the nose picker.
Smells set off hallucinations.
Sensory deprivation should get the brain into an alpha-theta phase.
Didn't you see Altered States? I don't think I was even born when that movie was out.
Then you're too young to be a doctor.
That movie was released in 1980.
That was 28 years ago.
No it wasn't.
Shut up.
Did you just forget what year it is? No, I just remembered how old I am.
I need to give my brain time to transition so I can embrace my inner monkey.
Or maybe I don't.
Get me some physostigmine.
It crosses the blood-brain barrier.
And act like a nerve gas, stop your heart, you'll go to heaven and be omniscient.
Good idea.
Not gonna happen.
Don't do anything.
Even if I escape, eat a goat or get shot by police.
"Wasn't born yet" means I won't be entertained by further reference.
I didn't know you rode the bus.
I used to drive home after getting drunk, but some mothers got mad-d.
What are you doing here? You weren't on the bus with me.
Then I guess this isn't a memory.
It's a fantasy.
If it's a fantasy, you'd be wearing this.
You're convinced your patient is dying and you wanna waste your time with a sex fantasy? Don't blame me, blame my gender.
Well, I'm not here to indulge that.
I'm here to help you figure out what symptom you saw.
Your patient was driving the bus, so all you could see Why can't you do both? Your patient was driving the bus, so all you could see was him sitting down, most likely facing forward.
From behind I saw his earlobes wiggling, or his head bobbing.
But not that.
Could indicate aortic insufficiency.
Marfan's syndrome.
Or syphilis.
What if his earlobes were just drooping? Ehlers-Danlos? Or Cutis Laxa.
It's not fatal in adults.
Yes, he's an adult, very good point, keep going.
I'm distracting you.
No! Dance, woman.
You'd rather be diagnosing.
I screamed no.
And your own subconscious ignored you.
Because you'd rather fantasize about finding symptoms.
How screwed up is that? Hey, over here.
Remember me? I'm the sick guy.
Tell me what I saw.
Was it the blood dripping from my ear? That doesn't make sense because your shirt wasn't stained.
And because that was me.
I could have had a subtle hemiballismus, indicating the early stages of Huntington's.
Huntington's wouldn't explain the abdominal pain, and it's only on the table because we're thinking of Thirteen.
A shuffling gait could suggest Parkinson's.
Except there's no such thing as "shuffling sitting.
" He moved when he helped the old lady up the steps.
Who are you? I'm the answer.
Look.
At what? Here.
You were right.
Help him up.
I got it, it's Parkinson's.
House.
Your ear.
Start him on levodopa.
You should sit down.
House! Get that out of my face.
Welcome back.
I'm Nurse Dickerson.
I don't need your name.
And I got your profession from your super competent technique of melting my retinas.
Verbal faculties seem to be intact.
Do you remember passing out? I remember puking on Cuddy's shoes.
Yeah, skull fractures tend to hurt.
Would hurt a lot less if you hadn't swiped my pain pills.
Dr.
Cuddy's orders.
Wants me to regulate the amount of Wait a second.
You brought muscle? Dr.
Cuddy's orders.
Means I was wrong.
My patient doesn't have Parkinson's.
Cuddy knows that's the only reason I wouldn't want to stay here with my pain pills, porn and you forever.
Vomiting means your brain injury is getting worse.
House's skull fracture extends all the way down to his ear canal.
House is being looked after.
Our other patient has jaundice, low albumin and no diagnosis.
Wilson's Disease.
Thank you.
But Wilson's wouldn't explain Foreman.
How did you eliminate Parkinson's? Tests confirm the abdominal pain was caused by liver failure.
I assume you've already ruled out hepatitis and Wilson's.
You should really be resting.
Give him five minutes.
Brainstorming a few possibilities isn't going to explode his brain.
And if she's wrong, that makes this phone call that much more exciting.
What about hepatic fibrosis? Can't be, his Alk phos was normal.
Could be thyrotoxic periodic paralysis.
Did I mention this diagnosis needs to make sense? Why doesn't it make sense? Bus driver's Asian.
His potassium's slightly low.
If he got paralyzed while driving the bus, don't you think I would have gotten off at the next stop? Not if the next stop was at a 90-degree angle into an SUV.
The bus would have slowed, I would've noticed.
Phone call's over.
TPP has all the confirmed symptoms.
There's no downside to testing.
Genetic test is too slow.
Run the bagel test.
How many more bagels do I have to eat for this to work? High carbs plus exercise is the quickest way to confirm TPP.
I've been on this for half an hour.
I'm not gonna collapse again.
Up the speed.
Keep eating.
Yeah.
So the carbo-loading marathon isn't working.
Stop looking around suspiciously.
To answer your next two questions, no, I am not there, and yes, you are completely predictable.
If the test had worked, you would have called to put my delicate brain at ease.
I told you not to lock the door.
Still wiping.
Put the phone up to bus driver's grill.
Who are you talking to? My large colon.
TPP's not consistent with your patient's labored breathing.
Patient has labored breathing because he's been on a treadmill for the last thirty minutes.
Did you take my cell phone? My large colon did.
I'm negotiating its release.
Help.
What's happening? The test worked.
He collapsed.
You're half right.
He's wheezing, isn't he? Yeah.
Can't wheeze without moving your chest muscles.
This isn't TPP.
Then what is it? How am I supposed to know? I'm not there.
Right heart strain.
He's still not oxygenating.
Must be a pulmonary embolism.
So why haven't you pushed a vial of tPA? You let him back in? I asked him back in.
At the tail end of me patiently explaining how you idiots were idiots.
Pushed tPA That means it's not a clot.
Has to be a clot.
If he had a bagel stuck in his windpipe, I would have seen it on the echo.
Get him to the OR to suck it out.
Must have just screwed up the intubation.
Seal's good.
It's a clot, House.
Wait, wait.
Look at his teeth.
He's got shiny new caps.
He's had recent dental surgery.
You can tell us what that means while we're rolling him to the OR.
House! House! House! Get a syringe.
I didn't bring you back here so you could stage a coup.
Listen to me.
Dental air drill pushed an air bubble into his gums.
Dislodged while he's driving.
Caused a myoclonic jerk.
That's what I must have seen.
Then it hit his spine, his liver, and now his lungs.
Dr.
Hadley, open the door.
I'm not plumping his pillows here, I'm putting him in the Trendelenburg position, move the bubble to the apex of his heart so you can suck it out.
Now get the damn syringe.
I can't risk you stabbing him in the heart looking for an unconfirmed air bubble.
Stab him.
Dr.
Hadley! See? She doesn't even know your name.
Stab his heart! Sats at 75.
Yes, he's suffocating.
If you're wrong Shut up and make a decision.
Keep standing there, he's dead either way.
Dr.
Hadley! I'm sorry.
Open that door.
Don't shoot! Get him to the OR.
The O2 sats.
It was an air bubble.
He's okay.
The other nurse always used to tuck me in.
I'll be on the couch, with a shotgun in my lap.
Worrying about me.
Making sure you don't try and make a limp for the border.
Get some sleep.
I'm not sleepy, Mommy.
Me neither.
Who are you? And why are you stalking me? Technically, you're stalking me.
What is that? A mosquito? Maybe just a fly.
In the ointment.
So there's something wrong, there's some detail I'm not noticing that's spoiling the big picture.
Is this significant? Or is this dream just going in a different direction now? Guess that depends.
What are you going to do with that? I have to tie this around you.
I'm cold.
Stay with me.
Why did I say that? Hey.
Go away.
It's not over.
I saved the wrong person.
This wasn't just a dream, or a fantasy, or a drug-induced trip to Wonderland.
So the bus driver with the air bubble was just a coincidence.
No.
I got the causation flipped.
The bubble didn't cause the crash.
The crash caused the bubble to dislodge.
There was no myoclonic jerk.
I saw something else in someone else.
You're not leaving.
What's the most dangerous thing a patient could do when his brain is on the brink of herniating? Elevated heart rate, BP, which is exactly why you need to stop.
Instead of sleeping, I'm going to be pacing around this apartment, trying to decipher those visions.
Why does this matter so much? I don't know.
Heart rate? BP? Contextual memory, I need to get back on that bus with all 31 passengers to remember who and what I saw.
I'm not gonna call in crash victims because you've gone insane.
Maybe I don't need the actual victims.
Who's playing Anne McKeon? Right here.
Jane Doe #2 from Princeton General? Right here.
You, too, that's right.
Goth Kid, at the back, on the right.
Yeah, here.
Okay.
You think that staring at pictures on our shirts is going to be more effective than hypnosis? If you'd stop talking, the re-enactment could stimulate activity in my hippocampus and parahippocampal cortex.
How long do we have to sit here before you are stimulated? Stop staring at my breasts.
And don't say, "Or lack thereof.
" You okay? What did you see? Just slipped away.
Is that Vicodin? No, just a little memory pick-me-up.
Physostigmine? Are you crazy? Alzheimer drugs will make your brain go into overdrive.
That's the point.
It'll speed up my neuronal firing, turn up the voltage on my memory.
And blow out your heart.
How many did you take? Just now, or including the ones I took on the ride over? House, this isn't worth House? Why are you here? You believe in reason above all else.
There must be a reason.
You have something to tell me.
Yes.
Who am I? That's asking, not telling.
Who are you? You know who I am.
If I did, I'd be passed out in bed instead of OD'ing on physostigmine on the 6th Street cross-town.
What's my necklace made of? Resin.
Who am I? I don't know.
Why the guessing game? Because you don't know the answer.
And if I don't, you don't.
But you know the clues.
I know what's bugging your subconscious.
What's my necklace made of? No.
Who am I? It doesn't make sense.
What's my necklace made of? Amber.
I have to tie this around you.
I'm cold.
Stay with me.
Just stay with me.
Sir, are you all right? Are you all right? Are you injured anywhere? They'll take care of you over there.
He's coming out of it.
Strong pulse.
You idiot! Your heart stopped! Amber.
What? Amber.
It was Amber.
She was on the bus.
You almost kill yourself, and all we're getting is drug-induced fantasies.
Have you spoken to her? She's probably working, she's been on-call.
I called her.
She didn't call How could she I don't know.
Jane Doe #2.
Female, late 20s, kidney damage.
Does Amber have a birthmark on her right shoulder blade? She was on the bus with me.
She's the one who's dying.