House, M.D. s05e07 Episode Script

He's got a good pulse.
Maintain head stabilization and flip him over.
On my count, guys.
Ready? Go.
Sir, we're paramedics.
The mailman saw you having a seizure.
We had to break down your door.
You know what your name is? On my count, one, two, three, up.
We're taking you to the hospital.
I can't.
No, I can't.
No, I can't Hey, buddy, buddy, we're trying to help.
Sir.
Stay out of my house.
You just had a seizure, you could have a stroke, a bleed in your brain.
Leave me alone.
and three seizures in the last two days.
So it's a bleed, a clot, a tumor, metabolic or infection.
Stick him in the CT and Can't.
I'm assuming he has a giant head.
Severe agoraphobe.
The world scares the hell out of him.
So we can only test him with whatever we can take to him.
Fun.
The agoraphobia a symptom? Only of being shot.
He and his girlfriend were mugged seven years ago.
It's when it started.
Anybody can hate humanity after getting shot.
It takes a big man to hate it beforehand.
How did you get this case, if he didn't come to the ER? I talked to him through his door when he had flu last year.
I run the Community Outreach Program now.
See? Perfectly reasonable explanation.
She's definitely not here trying to work her way back on the team and steal your job or anything.
It's a legitimate question.
He agreed to meet with us.
But even if I can get inside his house his brain is a black box.
We can pick this up in a minute.
What's this? Takeout menus.
But I'm hoping you'll come up with a better answer when everyone asks what we're talking about.
Last night Forget it.
I know this is awkward, but we need to talk.
There's a reason that we've evolved the feeling of awkwardness.
It tells us not to talk about things.
I was emotional because of the adoption falling through and you actually let your human side show for a moment.
That is why we kissed.
I just want to say thank you for not taking advantage.
You're welcome.
Any time you want to stop kissing, I'm there for you.
Portable equipment can't distinguish a bleed or a tumor, can't see vasculitis.
What did Cuddy want? I kind of hit that last night, so now she's all on my jock.
Wow.
She looks pretty good for someone on roofies.
The only equipment we have is a sonogram and a portable x-ray.
What part of "olivine, pyroxene and amphibole" don't you understand? Pyroxene? "Pyro" means "fire.
" They're indicator minerals.
You can't see diamonds, so you look for the indicator minerals.
I assume the diamond is the tumor or bleed or whatever it is.
Provoke a seizure.
The indicator is the increased electrical activity focused around the abnormality.
We do an EEG, see the focus see where the problem is, which tells us what the problem is.
The Formster and the Camster, kicking it old school.
Thank God she's not trying to steal your job.
Go do it, and search the home for toxins.
I agreed to talk, not to let you in.
You could be very sick.
We need access.
I'm just not ready.
Why does he have two locked doors? He must use this room as an airlock.
Deliveries in, garbage out, he never has to go outside.
Just tell us when you are.
We're not going away.
Seriously? You want her to admit that all he has to do is ignore us for a few minutes and we'll take off? He was shot, girlfriend killed.
He probably has post-traumatic stress disorder.
He doesn't believe in a just universe, he doesn't trust anyone.
Give him some honesty.
I shouldn't have implied we'd wait forever.
We've got a whole hospital full of patients.
We can give you a few minutes but eventually, if you don't let us in we're going to have to leave.
Just one person comes in.
No, we've got to search the whole house for toxins.
How about I examine you in one room, and my colleagues will do the search? I'm going to try to provoke a seizure.
I need you to look straight ahead, okay? Yeah.
Are you all right? Yeah, I just I haven't been in a room with anyone for a while.
Okay, can you just give me a second? Sure.
Okay.
You're the person I talked to through the door last year, right? Yeah.
You were nice.
And smart.
Kind of made me expect someone older.
I'm not that young.
Must have been scary being shot.
Don't do that.
Okay.
You don't know me.
I've got everything I want here.
I make a lot of money writing tech manuals.
I get stuff delivered.
I work out.
I see anything I want over the Web.
I'm happy here.
You don't seem very happy.
Right now I'm not.
Go away.
Did you speak to Cuddy last night? She's fine.
Why would it take anyone more than a few hours to get over misplacing a baby? You spoke to her? Kind of hit that, so she's all on my jock.
What? Huh! Everyone else thought I was kidding.
You "hit"? Like making out or full-on sex or I've got a chart laid out with all the bases, I'll take you through it.
What are you going to do? What can I do? I'm gonna ignore her for the rest of my life.
This mosquito bite kept me awake Don't care about the bug bite.
She's your boss.
So now I have two reasons to ignore her.
It was just a kiss.
There's a reason Yes, those large things in her bra.
you were hiding it from me.
Means it meant something to you.
Yeah, I fiendishly concealed it within the phrase "I hit that.
" Stop scratching, you'll draw blood.
Finally, you said something useful.
I'm just gonna break the skin and let the poison out.
If you dated Cuddy, there would Sorry, I get better reception when you're not here.
What do you got? His place is totally clean.
No animals.
No hidden drugs or alcohol.
No lead in the paint.
And since you're not breathing hard I assume you're not holding Cameron aloft in triumph, which means no seizures.
Hey, speaking of breathing hard Cameron, you engaged to Chase yet? Sorry, we should have clarified.
We're calling about the patient, not Dr.
Cameron's love life.
We aren't engaged.
Moves things along much faster if you just give him the answers.
Seizures can also be induced through After six years? A year-and-a-half.
Through sleep deprivation or Sleep deprivation would take too long.
You living together? We spend most nights together.
There's a bunch of drugs that can lower a seizure threshold.
And cloud the diagnosis with side effects.
His place or yours? His, usually.
Interesting.
You would have said "interesting" no matter what the answer.
And no matter what the answer, it would have been interesting.
No engagement, commitment issues.
His place, control issues.
Not sure whose, but, interesting.
Yeah, moves much faster this way.
Where was the patient when he had his first seizure? In his entry hallway, getting his mail.
And getting close to the outdoors.
It spooked him, raised his BP.
Now use that fear.
Bring him outside.
He punched out a fireman.
We're doctors, not bouncers.
Okay.
So bring the outside to him.
Floor's genuine wood.
Why are they here? They overheard me announce the half-price bank foreclosure in the ER waiting room.
Where is everybody? Cameron's with the patient, everybody else went home.
Because they don't need to be here.
Neither do you, and yet you are.
This way.
Moldings original? Original? They were here before the house.
The shut-in is also original.
Come on, don't be shy.
House, get them out of here.
Easy for you to say, you're not going to be making some serious capital gains.
This is cruel.
And leaving him undiagnosed is what, altruistic? Procedure worked.
He's seizing.
What do you see? Normal theta, normal delta.
This isn't a seizure.
It's something.
Mr.
Nozick, are you okay? My stomach.
It's killing me.
See? It's something.
Partial small bowel obstruction.
Blockage explains the pain.
What explains the blockage plus seizures? Atrial fibrillation throwing emboli.
Crohn's causing an abscess.
It could be a million things.
There's no way to know unless we get him in for an MRI on his head or exploratory surgery so we can biopsy his bowels which he won't let us do.
Wouldn't.
Pain changes things.
House.
He told you to stay out of here.
He can chase me out once he's done doubling up in agony.
Whatever your big problem is has caused a complication we call "colon FOS.
" "F-O", "full of," since we're in mixed company, "S" is "stool.
" Nothing is coming out, so the pain's gonna get worse and worse.
So we need to stick a pooper scooper in you.
We also need to take a look at your bowel.
I made my wishes clear.
Uh-huh.
And, see, if the Crazy Fairy were here she could grant them.
I'm not insane.
I feel pain when I go outside so it's rational to avoid that pain.
Except now you're feeling pain inside.
Well, not as bad.
Nowhere near.
We can give him drugs for the blockage.
If it doesn't work that blockage will rupture your intestines and spew sewage throughout your body.
Whatever you're scared of out there, aren't you more scared of death? You, obviously, can't stand people.
But for me, it's worse.
All right? I'd rather die in here than live out there.
If you don't mind floppy hair and an annoying accent I know a surgeon who will operate in your home.
Thank you.
With the risk of infection, Chase won't actually He's not gonna do surgery in some crazy dude's house.
You just said What I said was that Chase would put him under at the house.
We take him to the hospital, open him up, do our thing then slip him back into his room for the post-op without him ever finding out that we tricked him.
So, that was implied.
It's unethical.
He'll be asleep.
He gets to make his own calls, even if he's asleep.
Why are you siding with him? Oh, yeah, you're that girl who likes broken people because her husband died and since Chase isn't all that broken Hey, why don't we operate on his infarcted leg while we're at it? Who cares if he said no? I was risking my life to avoid becoming a cripple he's doing it to avoid sunlight and fresh air.
We've got to make it look good.
I know I'm a pain in the ass.
I know it would have been easy just to walk away but you're a good person.
Count down from 10.
Ten, nine eight Let's go.
How you doing? Better.
Great.
Everything else good? Everything involving me kissing House is good.
Oh, God, you dragged it out of me, you're a genius.
It's no big deal.
I was feeling vulnerable, he's a friend, and I leaned on him.
It's funny.
I've leaned on friends in the past.
Never leaned so far my tongue fell into their mouths.
I don't think of House that way.
I never have.
Why not? You know exactly how it would go.
It would start off exciting we'd get caught up in the novelty and the hostility and the forbiddenness and then we'd realize that the flirty hostility is just hostility his inability to open up is no longer exciting it's just frustrating, and then it's the inevitable blow up and the recriminations, and we don't talk for two months.
Yeah.
Well, it certainly proves you've never thought about House that way.
I get your point.
I will be more careful with my tongue in the future.
That's not my point.
Maybe novelty and hostility and forbiddenness doesn't have to end bad.
Got to go.
What time you done? Thought we could try that new sushi place next to my house.
Why don't we stay at my house tonight? But we always stay at mine.
That's what I mean.
We used to split, what happened? I don't know, I'm closer to work.
By five minutes.
And my house doesn't look like it was decorated by a drunk rugby player.
Well, we can discuss it.
I hadn't really Why does it have to be a discussion? Can't you just stay over? You do know they page me when that much surgical equipment is signed out.
He didn't consent.
He consented to the surgery.
You think he's going to sue over where? He won't even know where.
He'll wake up in his house, he won't know a thing about what happened.
Until he catches a post surgical infection in his dirty apartment and finds out we tricked him and winds up owning the hospital.
Why aren't you arguing with her? Because she's right.
I don't care where he gets the post-op, just that he gets it.
Keep him here.
House? You okay? Yes, we don't need to talk.
Your hand.
That's weird.
I usually don't get the stigmata until Easter.
Please tell Dr.
Chase the patient's ready for him now.
Stewart, wake up.
It's Dr.
Cameron.
If you can hear me, blink.
We were concerned for your safety, so we brought you to the hospital.
No, it's okay.
No, it's okay.
Why'd you I just wanted to keep you informed.
I didn't want you to have a bad shock while you're recovering from surgery.
I got to get out of here.
It's okay, Stewart.
Calm down.
Calm down.
Stewart.
Stewart, I'm going to sedate you.
I got to get out of here.
I'm gonna sedate you.
No! Calm down.
I need some help in here.
Damn it, somebody get in here.
What did you do? Well done.
Your patient called his lawyer, threatened to sue us is now heading home completely undiagnosed.
He'll soon be on his way back.
He's sick.
He'll crash, he'll lose consciousness and I'll declare an emergency, bring him back in.
Not any more you won't.
His lawyer now holds his health care proxy.
The next time we have an emergency Larry Ruseckas, Esquire, will be calling the shots.
I made the right call.
If he had flipped out after major surgery it would have been worse.
The benefit of being boss is that I don't have to argue.
You're all off the case.
What's going on between you and Cuddy? Bad loving gone bad.
Seriously, why didn't you argue with her? She just threw us off the case.
Because ignoring her is a lot easier.
Convince the patient to let us back in again.
See if you can clear his blockage with lactulose.
If this thing kills him before we can diagnose, it won't be fun anymore.
Okay.
You're going to keep working on this? Yeah.
I brought in the case.
There is no case.
He's gone, you've been tossed.
This is totally nuts.
He's incredibly sick.
We don't know Fine, forget about the patient.
What is going on with you? This is why we left House's team.
To avoid this constant flood of pure craziness.
That's why I left House.
You got fired.
I'm sorry.
I know I let you down.
But you know who else I let down? Pretty much everyone who's important to me.
My boss, my old boss my boyfriend.
I did that for you.
I'm not gonna let you down again.
It's like the red badge of idiocy.
If the Confederacy had mosquitoes we'd all have Southern accents, and I'd be paying Foreman less.
She kicked you off the case.
This is what happens when you don't address it.
She acts weird, things get different.
You understand that different implies difference? She's tossed me a million times before.
No, she always chastises you and you'd always come running to me to complain so you're acting different, too.
You're scared.
You are scared to get involved.
How is that scared? It's rational.
Emotionally mature people who work together should not date.
Guaranteed break-up, guaranteed ugliness.
Any relationship that doesn't end in a break-up, ends in death.
Everything falls apart in the end.
That's your worldview.
The corollary, which you keep forgetting is that you have to grab any chance for happiness.
Why does this matter so much to you? Cuddy and I are fine.
The only person getting worked up here is you.
I don't want you to be fine, I want you to be happy.
I think if you dated her Are you familiar with the adverb "vicariously"? If I wanted to ask her out You did ask her out.
Last year.
Whatever happened there? I don't know, I wasn't interested.
Wrong.
You were interested, but Amber grabbed your genitals first.
And now you're single, and it makes you miserable but you think it's too soon for another relationship so you're gonna make me miserable.
Please.
Get a girlfriend or a life or something.
For me.
Better or worse? Worse.
Drugs aren't working.
I think we should do the surgery in his house, like we planned.
Well, then one of us wasn't paying attention because I thought that surgery thing was just a trick.
We prepared the room.
We hung the drapes.
It's probably 10 times as sterile as any mobile operating theater you'd find in a battlefield.
We still need Trapper John.
Chase doesn't want anywhere near this surgery.
Maybe you could talk to him.
I can't understand a word he says.
Taub, you doing anything later? Blood in the field.
Not where I'm looking.
How am I supposed to know where you're looking? Here's a hint.
It's the bloody part.
The whole thing's bloody.
It's a guy with a hole in his body.
It's like you've never done this before.
Use the suction.
I will.
And, in fact, I've never done this before because I went to med school, not nurse school.
Hey, wanna see if your client's actually made of money? Cutting out the last piece of bowel.
Suture.
Mucosa's pink.
Flattened villi.
Intestinal atrophy.
It's Whipple's Disease.
Explains the seizure and the stomach pain.
Little bleeder here.
Cautery.
Hey, wait, the gas That always happens during surgery.
It's the gas build-up in the blockage, nothing to sue about.
Treat him for the burns, put him on antibiotics for the Whipple's.
He'll be fine.
Hey.
That's nice of you.
Hi.
Hi.
He doing good? Burns are healing fine.
He's stable otherwise.
Good.
So, I could stay at your place tonight, if you like.
I can't.
Well, you're not gonna sleep here again? You might have noticed the lack of nurses.
Because you're not on the case.
You can't really use that as an excuse for Dr.
Cameron.
Wait here.
Your stomach? My legs are numb.
I can't feel them at all.
New symptom, peripheral neuropathy.
Got worse on antibiotics.
It's not Whipple's.
- Porphyria.
Liver's fine.
Amyloidosis.
We'd have seen it on the intestines.
What did we see on the intestines? Pink mucosa, flattened villi.
If it's not Whipple's, it's gotta be celiac.
Wheat allergy means he's not absorbing nutrients.
Explains the seizures, the stomach and now the nerves.
We should run a blood test for celiac.
Not fast enough, not accurate enough.
Force feed him wheat.
Then do an endoscopy as it hits his duodenum.
See if there's an allergic reaction.
His guts just exploded.
It might be a tad painful to make him eat.
That's House's point.
There's nothing diagnostic about it.
He's trying to put the patient in pain, force him to come in.
It is a valid test.
So is the blood test, which is painless.
Foreman, listen to that little voice in your head that's coming from the telephone.
Force feed him.
Don't.
You know House.
You know I'm right.
We'll do both tests.
I'm not here to play matchmaker.
Okay.
House basically Well, he accused me of being interested in you.
He's just trying to change the subject.
I know.
But I do have I've always had some feelings for you.
Are you saying you want to date me? No, I It wouldn't be fair to House, and it's too soon after Amber.
But you thought you should just say it? Yeah, I thought you should know.
Let's have dinner tomorrow night.
Okay.
Or maybe it'd be better if we just had sex.
Pardon me? In front of House's office.
I mean, I don't want to take any chances.
I assume the point of this is to make him jealous to make him realize that he does want a relationship with me.
Yes.
You think it'll work? You're an idiot.
Trust me, everybody will be happier if House and I aren't dating.
You sure this is the best test? No.
But you've kind of tied our hands.
As soon as this hits your intestines, I'll look at it through an endoscope.
Stewart, I know you don't want to talk about this but people who get shot often get PTSD.
It's nothing to be ashamed of.
It's very treatable with drugs and therapy.
It's not PTSD.
My girlfriend was with me when I got shot, and she died.
I'm sorry.
But that's what I mean.
I lost someone myself.
I know it's traumatic.
No.
What I'm trying to say is that I was like this before the shooting, since I was a kid.
Everything was hard for me.
I didn't go out that much, and when I did I had panic attacks, like, physical pain.
You know, it was, like, worse, it was like I was dying.
When I met Angela she was the only reason that I ever wanted to go out.
But then she died, and Blood test will be done soon.
I'm guessing that's a new technique.
Hey, do you remember that idea that Cameron had about trying to torture the patient into admitting himself? Pretty sure it was your idea.
You want me to slow down the test? Wow, everyone's got all these great ideas today.
So you're thinking, "Patient won't leave because leaving causes pain "so we gotta make staying more painful.
" That actually makes sense.
You'll increase his pain, but not enough to make a difference.
He's on morphine.
He's on morphine now pretty soon, he'll be on lessphine.
'Cause when you restock, you'll actually be giving Cameron IV bags of saline.
And why do you think I'll be doing this? Same reason you did the surgery.
That was because it was an emergency.
No, it was because your marriage is falling apart.
When you confess adultery, things tend to go bad.
When one part of your life does a Titanic you make a life raft out of whatever's left which makes your job more significant, which is why you did the surgery why you pulled an all-nighter, and why you'll do this.
She's having me sleep on the couch just for a few nights.
I'm not doing this to save my job.
I'm doing this to save his life.
Right.
That's what we'll tell everyone.
Oh Have you considered that it's not my place you really wanna be walking into right now? Ric Ocasek will kill me if I Oh, you mean Cuddy.
Yeah, she's a little nuts, but she's beautiful, smart, funny.
And most important, she can stand you.
Yeah.
I came here to have you lecture me on Cuddy not because there's a killer mosquito chasing me around my apartment.
House, there is no mosquito.
This is all about Cuddy.
She's "bugging" me.
Poetic.
Have you seen this bug? Have you seen this bite? No, what I've seen is a suppurating wound that you've scratched and mutilated into a gangrenous state.
Delusional parasitosis.
I am not imagining things.
House, you're a drug addict, you're always imagining things.
You got bitten the night you kissed her.
Your itching always gets worse when you think about her.
You need to address this.
She's my boss.
No, you're not afraid of authority, you're afraid she actually is right for you.
You're afraid to take a chance because it's too big a chance.
If it doesn't work with her then maybe there's no one out there.
I am not rationalizing.
I'm better off alone.
Also, have you seen her ass recently? You're not staying here.
Oh, come on.
No.
You can go home, or You're going to Cuddy's, you're gonna ring her doorbell and you're gonna ask her out on a date, like regular people do.
At 3:00 in the morning? When do regular people sleep? Bye-bye.
Is he in enough pain to come in yet? No.
Antibody tests back? Inconclusive.
Then why are you here? I missed you.
Endoscopy? Inconclusive.
Well, then do it again.
I know it sucks, but I need to test your stomach again.
It's really hurting.
I know, I'm sorry.
I'm gonna try to get you on your back and have you open your mouth.
He's out.
Anything? No pulse.
Start CPR.
Get the paddles.
Get the paddles.
Who are you calling? Pizza.
You like anchovies? I'm calling the lawyer.
Genuine emergency, he'll okay admission.
He's dying.
Exactly.
Hi, sorry to wake you.
Your introvert is having a heart attack.
House, if we don't restart his heart He can survive 15 minutes on oxygen and CPR.
We can get him to the hospital in five.
Lawyer says yes.
Continue CPR.
patient with PEA.
Clear.
Wait.
I got a pulse.
Cancel the ambulance.
He's stable enough to stay here.
His heart's back to sinus rhythm, but it's bradycardic.
Taub's putting in a temporary pacemaker.
It'll keep his heart beating for now.
Hey, Cameron, how would you like your old job back? I'm asking 'cause it's the only way I can fire you.
Sorry, in ER we like to actually resuscitate dying people not just let them flop around.
Could be lymphoma.
No, we'd have seen it on the abdomen.
It has to be a poison.
Organophosphates.
We checked the place over and over.
It's completely clean.
There were rose petals in the front entry.
Unless he's eating a bouquet a day he couldn't How clean? Very, he probably has a little OCD.
How often do you wash your tub? Every couple of days.
Bleach and ammonia? Yeah.
You know how kids play toy soldiers in the bath? He likes to re-enact the Battle of Ypres three times a week with real gas.
Ammonia and bleach makes chlorine gas.
Highly fat soluble.
He lost weight after the stomach pain explains why his symptoms kept getting worse.
Put him on parenteral steroids and sodium bicarbonate.
Even if you're right, that external pacemaker's gonna fail eventually and I don't have the skills to put in a permanent one.
Well, maybe the poison hasn't completely shot his heart and you won't have to feel guilty for the rest of your life.
How am I going to place the leads in the exact spot on the right ventricle without fluoroscopy? The Force? Taub put in a temporary one.
You can do that playing Pin the Tail on the Donkey.
Permanent pacemakers need precision.
So we can use the portable x-ray.
It's not real time.
Sonogram.
And what happens when I put him into V tach because the sonogram isn't precise enough? He's dying.
Exactly why I don't want to be the one to kill him.
Thanks.
You knew I'd have to say no, but you came anyway.
You just wanted a reason to be angry at me.
If there's something wrong between us, then let's Forget it.
You know why we spend nights at my house? Because when we spent them at yours I could tell you didn't want me there.
Why would I keep inviting you over if I didn't want you there? You always kicked me out every morning.
You never offered me a drawer, you never cleared out your closet for me.
I was just a visitor.
How long have you felt like this? From the start.
I know it's hard for you because you lost your husband but I can't keep chasing you forever.
I just tried your house, where are you? Clubbing.
Good or bad? Bad.
Vitals are dropping, the abdominal pain keeps getting worse.
Means we were too late with the treatment.
Tell the lawyer he's off the clock, we're done.
You're giving up? Call Taub.
Tell him to pick up some morphine.
No need for the patient to be in pain.
He's on morphine.
No, he's on saline.
I figured you'd put him on saline, so I switched him back to morphine.
I love you.
When you reach puberty, give me a His abdominal pain, that was on morphine? Yes.
Is there something that causes abdominal pain that doesn't respond to morphine? I was right.
He is being poisoned.
What's this density on his hip? Just bone.
Think less boney.
You think he's got lead poisoning? Explains the constipation, the nerves, seizures.
Hold him down.
You're not gonna feel a thing, except excruciating pain.
Your mugger used hollow points, which exploded and left fragments.
Your doctors missed a couple hiding behind your hipbone.
It's no biggie, except years later, they started to dissolve and then, biggie, you started to dissolve.
I'll start him on chelation.
The agoraphobia, could it Nope.
The lead wouldn't have started to disintegrate till years after.
But it could have exacerbated the fear.
I don't need to change.
I know you think that but your life could be better, you'd have choices.
He's lying.
About what? About everything.
About his life.
He doesn't even think he's happy here.
He's miserable.
I've got everything I need.
Yeah? Well, then why did Taub find rose petals in your entry hallway? Struck me as a little weird, thought it might be medically relevant.
But it actually just told me that you were pathetic.
The day you crashed in your entryway was your girlfriend's birthday.
You weren't there for the mail, you were trying to go lay flowers on her grave.
Yeah, he's got PTSD, yeah, he's agoraphobic.
But he's also a coward.
If you want to change your life, do something.
Don't believe your own rationalizations.
Don't just lock yourself up and pretend you're happy.
Hi.
Hi.
You were right.
About my husband.
It affected me.
It still affects me.
If you're saying you'll never be able to I cleaned out a drawer for you.
Like, a big one.