House, M.D. s05e16 Episode Script

I want to reassure you.
Your child can have a completely normal life.
How can a baby have male and female DNA? It's a condition called genetic mosaicism.
The ambiguous genitalia can be surgically repaired.
Repaired? Made to look more typical.
More typical? But you haven't even told us if the baby's a boy or a girl.
That's a choice you have to make.
Nice job, Jackson.
Take it.
He had the shot.
He lost his nerve.
Honey, it's okay.
He's doing great.
Three.
No fear that time.
Melanie.
What? Oh, my God.
Jackson! Black heels or the boots? You know I'm a fan of those heels.
Boots it is.
For all we know, House knows you're a fan of those heels.
You think House is going to figure out we faked our break-up because of your shoes? Go with the boots.
You gonna eat that? Have at it.
Did you just ask my permission before you took my food? Yes, we can.
Adolescent genetic mosaic, collapsed during a basketball game presenting with persistent pelvic pain.
Fun.
The parents haven't told their son that he could have been their daughter.
They want assurance that you won't either.
Less fun.
But still.
That was easy.
Our new patient.
Part girl, part boy all Thirteen's dream date.
Severe pelvic pain started during a basketball game.
Could be dehydration.
ER gave him fluids when he came in.
Still, if it was chronic We got a kid who could mate with himself, and we're thinking he didn't have enough to drink? There are dozens of intersex disorders.
Persistent pelvic pain could mean congenital adrenal hyperplasia, PMDS.
Those conditions occur in intersex kids who are chromosomally XX or XY, not XX and XY.
Parents recently started him on testosterone, maybe there's something Vitamins wouldn't cause pelvic pain.
There's a note in here.
We're supposed to refer to his testosterone shots as vitamins.
His parents aren't just liars.
They want us to be liars, too.
I won't do it.
You guys will, though.
He's a kid.
Parents don't think he's ready to deal with it.
My dad was the same way about me maybe having Huntington's.
It's Well, if that was your experience it must surely apply in this situation.
Pain could be caused by a blind uterus hidden in his abdomen.
He needs an MRI.
Right.
Boy with girl genes.
I'm sure you're the first doctor brilliant enough to check for a uterus.
He could have complications from the surgeries on his penis.
That can cause pelvic pain.
Way to multi-task.
Impress your boss and humiliate your ex.
MRI is a waste of time.
But to continue the humiliation go put a camera up his penis.
You're Dr.
House, aren't you? What do you think is wrong with our son? These people were just coming to tell you.
This is better.
Don't have to worry about them losing their way.
We think that he has a blind uterus.
He should have an MRI.
Did you send them a text? Over the past 13 years, we've educated ourselves.
Who needs med school when you've got Wi-Fi? Go schedule their son for an MRI with contrast right away.
Thank you.
Thanks.
You just said an MRI was a waste of time.
So is arguing with them.
Contrast's in.
Jackson, we're going to get started, so try to lie still.
How long do you think the post-break-up awkwardness is going to last? Foreman and I are both professionals.
Stomach and liver are clear.
If by "professional" you mean he's a T-1000 built by Cyberdyne Systems.
I never understood what you saw in him.
He's not really your type, huh? Moving down through the pelvic floor.
Here's my impression of Foreman on the happiest day of his life.
Now, the saddest day of his life.
We just broke up.
I'm not quite ready to mock him yet.
House was a jerk to split you two up but bottom line, he did you a favor.
Area around the intestinal tract is clear.
No blind uterus.
I think there's something wrong with House.
Who's he making miserable now? Actually, no one.
He okayed an MRI just because the parents wanted to look for a blind uterus.
There was no fighting, no arguing, he just went along.
It's a valid medical theory.
He doesn't think it is.
House decided to humor these parents.
Maybe he had a great cup of coffee or a tremendous bowel movement.
Bottom line is, your boss is in a good mood.
Stop analyzing it and just enjoy it.
We're going to use this scope to fill your bladder with saline then examine your urethra for any narrow spots.
Why would there be a narrow spot? Sometimes it just happens.
Can my parents come in? Sure.
I thought it'd be awkward for you having them here.
I have this feeling they've seen me naked before.
Now, take a breath, just try to relax.
Mom.
It's okay, honey.
It's okay.
Hey, remember those sprints they made you run in practice? Those were so hard, but you pulled through.
You can do this, too.
I'm to the bladder.
Start the saline.
I'm going to look around and pull back on the scope.
Feels tight.
- That pressure's normal.
Just try to hold on for a few more minutes.
It's not down there.
It's my chest.
I can't breathe.
Can't Can't breathe.
Is he okay? Muffled heart sounds.
Jugular's distended.
Pericardial effusion.
We need a 10 gauge and a syringe.
What's happening? His heart is filling with exudate.
If we don't drain it, it'll stop beating.
We drained the fluid from his pericardial space.
His heart rate is back to normal.
Pelvis plus heart doesn't fit with any of the syndromes associated with mosaicism.
It could be drugs, toxins, an infection.
You're okay with this? With what? That we're considering a diagnosis unrelated to this kid being a she-male.
Assuming a coincidence like that would usually torture you but you're completely unfazed.
Completely unfazed? You think I'm totally lacking in any fazing? The idea that I'm anything less than half-fazed, I actually find offensive.
It greatly fazes me.
He started testosterone Vitamins.
a few months ago.
That can cause autoimmune diseases like polyarteritis and SLE, which can cause pericardial effusion and pelvic pain.
So, it is related.
Now I'm unfazed.
Start him on corticosteroids for the autoimmune finasteride to block the vitamins.
You slept with House.
He asked permission before taking my bagel took the case without a fight honored the parents' request for an MRI.
Yes, those were my terms for sleeping with him.
He's in a good mood.
Sex with me would explain that but it doesn't explain why I'm not curled up in a ball, weeping in shame.
I did not have sex with House.
If you two aren't keeping something from me that means he's keeping something from both of us.
That can't be good.
Or he's just in a good mood.
This is not a crisis.
Maybe you can get back some of that money he owes you.
Hmm.
Testosterone blocker? Does that mean if Jackson has SLE, or whatever that other thing was that he'd have to go off the hormones? Probably.
Then Jackson will stop developing he'll never go through puberty.
Maybe this isn't what's wrong with him maybe the testosterone didn't cause it.
Yeah.
But if it is, then he'll never be a man.
Did we make the wrong choice? You'll need to tell him the testosterone blocker is something else.
Or maybe this is a good opportunity to tell him the truth.
It might make it simpler for all of you.
You want us to tell a sick adolescent boy that he's really not an adolescent boy? That doesn't seem simpler to me.
No.
Just give him the meds.
So, you have pain in one arm and both your legs.
Does it hurt right now? No.
It's when I, like, put pressure on them.
See, it hurts when I do this.
Ow! And this.
Ow! And this.
Ow! What about this? Ow! Did you give House the moron with the broken finger? They've been in Room 2 about 10 minutes.
The patient should've been screaming for another doctor seven minutes ago.
Thanks, bro.
If I have this IV, why do I need a shot, too? Just some extra medicine, just to be safe.
I hear you're quite the basketball player.
What position? Point guard.
Small forward.
How's your crossover dribble? It's okay.
I'm not really that into basketball.
Gonna feel a little pinch, okay? So, if you're not that into it, why'd you join the team? My mom kind of made me do it.
My parents were the same way always pushing me to try new things.
It was more like what she didn't want me to try.
I wanted to take dance, but she flipped out and made me choose between basketball and hockey.
What does your dad say? He seemed okay with it, then he just caved in to my mom.
Your palm is red.
What does that mean? That we still don't know what's wrong with you.
You were right, he is in a good mood.
Bummer it didn't work out with you and Thirteen.
It happens.
You guys seemed happy together.
It's probably for the best, you know, the bisexual thing and all.
That was never an issue.
No, it never is.
Until it is.
This is Thirteen.
Before you guys got together she was hooking up with a different girl every night.
Long term, you really think you could compete with that? House, wake up.
We have to talk.
Stop pretending to be asleep, we're not leaving.
House.
What's going on? House? He's not breathing.
Can you get a pulse? Barely.
Call a code.
Get an Ambu bag from the nurse's station.
Heart's still working, means synapses are still firing.
We just need to get a message through to him.
You stopped breathing.
What the hell is going on? I think my penis stopped breathing.
Do you know CPR? Looks like your brain is okay.
Pupils are equal, round and reactive.
I'm fine, other than the fact that my nurple is now purple.
No wonder you broke up with him.
I'm surprised yours are still attached.
By the way, I could see that from here.
I assume those are our patient's lab results.
The patient can wait.
You could have died.
The only reason you'd ignore a near-death experience is you don't care or you already know why it happened.
It's called Vicodin.
I took too many.
Can I please get some information about our patient? The patient's palms are red.
Lab test confirmed liver and kidney dysfunction.
I don't remember you taking any Vicodin today.
I don't remember hiring my mother.
And what causes the enzymes in little Boy George's existing heart problem and pelvic pain? You didn't take any yesterday at breakfast, either.
I don't remember having breakfast with my mother.
Amyloidosis with systemic involvement.
Protein levels are normal.
This kid's depressed.
If he's self-medicating with drugs and alcohol that'd explain his symptoms.
Search the school.
Search the home.
Seriously? Or are you just deflecting? Both.
Where are you going? Nowhere.
I'm staying right here, so we can properly discuss this.
He's on heroin.
How can you Number one, he's happy, which means he's high.
Number two, when he moved his bad leg, he didn't use his hands to support it.
Whatever he's taking, it's stronger than Vicodin.
What are we gonna do? You really think House took too many Vicodin? Guy pops them like candy.
I'm surprised it hasn't happened before.
Do you miss sleeping with women? Excuse me? Simple question.
Yes.
It's a simple answer.
I'll check under the bed.
I also miss sleeping with other men and I'm sure you miss sleeping with other women.
Monogamy is like saying you're never going to have any other ice cream flavor besides Rocky Road.
So, you're saying if you don't have pink bubblegum for a while that one day you're gonna chase down the ice cream truck? No, Rocky Road is great.
It's a very delicious and complicated flavor.
I also know that if I have other flavors then Rocky Road is gonna be left in the freezer where anyone can just dip in.
Can we please drop the metaphor? Why is this coming up now? Kutner said the silver lining of our break-up was I wouldn't be dumped for a girl.
There's nothing in here, either.
Seems like you're wrong about this kid having drug or alcohol When did he bring that up? Earlier today, right before This morning, Taub called you a robot.
Hmm.
Either it's a big coincidence or they're jerking us around, they know.
And if they know, House knows.
This is bad.
No, this is good.
House only has two ways to handle us still going out.
He jerks us around or he fires us.
He chose option A.
This is good.
But this is bad.
"I stand alone, my soul and me, beneath the mask that others see" His chest is still rising.
He's just screwing with me 'cause Cuddy made me baby-sit.
"A pain that tears and bites and will not bend "Only when I sleep will it end.
" Downer.
And medically irrelevant.
You sure his chest is moving? House.
If he's faking, you think he's going to come clean because you said his name? Back off.
Only Thirteen gets to grab my nipples this time.
You know, recreating the moment when you made us crap our pants isn't actually all that funny.
That is sweet that you're worried about House.
Unless the next stanza reads "Hoping to fry my brain to death I smoked some primo crystal meth," I'm not interested.
You can't deny that this kid may be suicidal.
We're not here to make him happy, we're here to diagnose him.
It's an infection.
Swab of the kid's water bottle turned up toxoplasmosis.
I'll start him on pyrimethamine.
I had no idea he felt this way.
Is there a therapist here that you can recommend? It might help more if you talked to him.
He's not ready.
If telling him the truth would help him stop feeling like this.
If I knew that it'd make him less confused I'd tell him right now.
But if she's wrong, we'd only make things worse.
He obviously senses he's different.
He's looking for answers.
Every teenager feels different.
He's sick.
This isn't the time to spring this on him.
Okay.
When you give Jackson the antibiotics will you please re-start the testosterone? Sure.
I get House wanting to jerk me and Thirteen around, but you guys? Told you they were still together.
How'd he know? He noticed you smell like Thirteen's soap every morning.
You figured it out? Yes, I'm a little slow.
Maybe someone should let me know when I should be insulted.
Then House doesn't know.
Probably does now that you felt her up during that last differential.
You noticed this, but House didn't? Yes, I get it.
He's generally smarter than me.
Can we please move on? He's not generally smarter than you he's always smarter than you.
Unless Hello? House is on heroin.
Well, that's certainly an interesting notion.
It's why his lungs stopped, it's why he okayed the MRI it's why he missed things he wouldn't ordinarily miss.
We'll run some tests, and I'll let you know.
He's there, isn't he? Well, that would certainly explain the inappropriate responses.
I got to go.
Okay.
Sorry.
Consult.
When did you order these? When you were in the bathroom.
I thought a celebration was in order.
To cheating death.
You off bourbon? Can I get you something else? I came here expecting a burger.
Figured I'd have to endure a little lecture on moderation.
You never listen, so why But instead, I get a drink.
A nice little serving of respiratory depressant on the day that my lungs stopped working.
You seem fine now.
You don't believe that I OD'd on Vicodin.
You figure I'm on something stronger.
And because you can never, ever assume anything but the most screwed-up scenario as far as I'm concerned Funny how I'm usually right.
you think that I'm on heroin.
This is your version of a tox screen.
Because if I am on heroin I can't drink that without risking another bout of not breathing.
Well? Good night.
Another shot? I'm afraid so.
That looks like the vitamins my parents give me.
Same red top.
These aren't vitamins.
What is it? I can't tell you that.
You should ask your parents.
You idiot.
Okay, I admit it.
I have bulimia.
I look good though, don't I? Heroin.
Heroin! House, of all the stupid I'm not on heroin.
I just caught you with your fingers down your throat.
I'm on methadone.
Stupid product, heroin without the high.
Yeah, and twice the risk of death.
But no risk of arrest.
You nearly died.
Today was a fluke, I nodded off.
Right, you're safe as long as you never sleep again.
Mis-time your dose, you die, couple of drinks, you die mix it with the wrong drugs, you die.
You want to detox from Vicodin pick something that won't kill you.
I'm not detoxing.
If you're looking for something to help with your pain.
It doesn't help my pain.
It eliminates it.
My leg doesn't hurt anymore.
She completely disregarded our instructions.
He asked a question.
I was tired of lying.
I didn't tell him anything about his genetic condition.
I want her removed from our son's case.
I'm sorry for the position Dr.
Hadley put you in, but I can't do that.
She's a valuable part of Dr.
House's diagnostic team.
If he stays on the case, so does she.
We have to deal with Jackson.
These questions aren't going to go away.
He's not ready for this.
Let's hope you're wrong.
I'm sorry.
I'll stay away from their son.
No, you won't.
In about 15 minutes, you're the only person that kid's gonna trust.
If he needs a hand to hold, make sure yours is available.
So, what, am I a boy or a girl? Some of your cells are male, and some are female.
So, basically, I'm a freak.
No, no, buddy.
You're just a little different.
You've known this since I was born and you never told me? We didn't want you to be confused.
So, you lied to me.
Oh, please, sweetie, we were just trying to protect you.
Don't.
Just leave me alone.
Get out.
Let's go.
You still breathing in there? Because if not, I'm sending in janitorial.
I'm not breathing, but it's strictly voluntary.
You should've seen the guy who was in here before me.
I know about the methadone.
It's legal.
I have a prescription.
Whatever doctor you conned into writing it clearly had no idea about your addiction issues, your lack of He knows I'm in pain.
What I put in my body is my business.
If you keep taking this, you could die.
If he'd said that if I keep doing this, you could die then it'd be your business.
I can't sit by and watch you kill yourself.
As long as you're in my hospital, you can't do methadone.
I'll send someone for my stuff.
That's it? You're quitting? You're choosing methadone over this job? I'm choosing lack of pain over this job.
Eventually you have to talk to your parents again.
No, I don't.
I have this one friend on my basketball team, Will.
We hang out a lot.
I really like him.
Now I'm worried that I you know, like him.
Maybe I'm supposed to.
Because if I'm really a girl Do you feel like a girl? I like dancing more than basketball.
Is that what that means? Jackson as hard as it is right now, at least it's out in the open.
You don't have to hide behind a mask.
I found the poem you wrote in your room.
No matter how bad things get killing yourself is never the answer.
This was an English assignment.
We were supposed to write a poem in the style of Sylvia Plath.
You don't feel this way? I'm sad sometimes.
But I don't want to die.
At least, I didn't.
Are these antibiotics supposed to make you nauseous? Yeah, they can.
We're on our own.
Is he okay? He's fine.
He's just not here.
Did he quit? Did she suspend him? She didn't say.
Just told me I was in charge until further notice.
So, if we add bloody vomit to our patient's list of symptoms Surgeon reports the bleeding was caused by a gastric fistula caused by necrotizing pancreatitis.
She must have told you something.
Nothing that would help us with this patient.
Heart, liver, kidneys and pancreas.
Obviously, whatever this kid's got, it's something systemic.
Zollinger-Ellison.
Or systemic scleroderma.
Zollinger-Ellison fits better.
Why? Can we at least call House? We can, I have, he's not answering.
Put the patient on proton pump inhibitors.
If he gets better, it's Zollinger-Ellison.
If not, it's scleroderma.
Zollinger-Ellison doesn't fit better.
You don't want it to be scleroderma because that means he's going to die.
Patients die all the time.
Not the ones whose families you've ruined.
I don't think that, you do.
It's not your fault.
He was no more confused than any other teenager then I started a fire and threw gas on it.
You were trying to help.
Hi, is House here? He's getting dressed.
I'll be back around 10:00 tonight.
Go on in.
Okay.
Who is she? I hired her to watch me sleep make sure I don't stop breathing.
Home nurses usually wear scrubs.
She's not a nurse.
You hired a hooker to watch you sleep? That just can't Surprisingly, hookers are cheaper.
They don't sue for sexual harassment.
Which one? You shaved! The red one then.
You have two ties? Meeting at St.
Sebastian's today.
I'm going to try and talk them into starting up a diagnostics department.
That sounds great.
I just came by to check up on you, see how you were doing.
I'm fine.
I guess you are.
He hasn't responded to the medication at all? I'm afraid not.
So, that means he's got the other thing? I'm so sorry.
We'll start him on anti-inflammatories.
If we're lucky, that will slow down the progression.
My son has a death sentence and I can't go in there and be with him because of you.
I'm sorry.
You find a homework assignment and decide he's suicidal make it your own personal mission.
I let my feelings Oh, don't you dare apologize.
Like it could absolve you of what you've done to me, my family.
He was fine.
I understand why you're angry.
But this isn't where you belong right now.
He won't let us in the room.
He's a teenager, you're his mother.
This is not the time to start listening to him.
Go be with him.
Thank you.
I didn't do it for you.
We made a mistake.
No, we didn't.
The methadone is good for him.
The methadone is gonna kill him.
He shaved.
He was wearing a tie.
He has a meeting at St.
Sebastian.
If he buys a new pair of shoes should we let him smoke crack? Cuddy, he's happy.
House doesn't do happy, pain or no pain.
Okay, maybe.
But he's our friend and this is his one chance to not be miserable.
The heels, very nice.
No reason not to wear them now that House is gone.
You okay? Yeah.
Just tired.
Got some good news.
The patient's scleroderma is responding to the anti-inflammatory meds.
His AST level has dropped a bit.
So, he's dying slightly less quickly than we thought.
That's great news.
I'm not okay.
Next time, just say that.
What's his AST? That's a pretty fast drop.
Are we sure it's from the anti-inflammatories? What else could it be from? He's been off the antibiotics for a while.
Proton pump inhibitors wouldn't He's back on testosterone.
Testosterone wouldn't help his liver function.
But it could improve his kidney function which would also lower his AST.
But not in kidneys damaged by scleroderma.
Which means it's not scleroderma.
I have an interview in two hours.
Wow.
Hand over my letter of recommendation.
Sorry, I haven't done it yet.
You have no right to sabotage I was busy with this.
It's a list of requirements for your methadone treatment.
Weekly drug tests, supervised doses administered on a precise schedule by me or one of the nurses.
Seems weird, getting my meds here when I'm working somewhere else.
Yes.
I'm offering you your job back.
I want a raise.
No.
And a bigger office, but in the same spot.
No.
We both know this is where you belong.
Okay.
Welcome back.
Thank you.
You're welcome.
You okay? I have issues with authority.
You? We thought you were gone.
Cuddy missed me.
And what happened to your cane? She asked to borrow it for some reason.
Patient dead, or do I need to do anything? He's got scleroderma.
It's not scleroderma.
Wow, two days and you've already got two separate theories.
You're back.
Good.
We noticed a drop in AST levels.
It's not from the anti-inflammatory.
It's because his kidneys got better from the testosterone.
Which rules out scleroderma.
When did you two come up with this? We ran into each other in the lobby.
So, what'd we miss? When I say "we," I mean you, since I wasn't here.
We've ruled out Zollinger-Ellison.
That was a dumb idea.
Why? Because it was wrong.
Also Toxoplasmosis, dehydration, SLE, various intersex disorders.
Oh, crap.
Does this kid like energy drinks? I saw some empty bottles in the team's locker room.
But energy drinks don't explain Nice work.
So, we're okay? Why wouldn't we be? Nice heels.
This is all your parents' fault.
Excuse me? You chug a lot of energy drinks before, during and after practice? Your son came in here with simple dehydration.
That's why he collapsed during the game.
The ER treated him for that.
It didn't help the pain.
That's where the energy drinks came in.
They put a strain on his kidneys so he needed more time to rebound from the initial dehydration.
Then why isn't he better? That's where your idiocy came in.
Before we could give him another glass of water you two insisted I do an MRI.
So, I go down a blind alley, looking for a blind uterus and my team injects him with contrast material.
If his kidneys had been healthy he would've filtered out the contrast in a couple of hours.
Since they weren't, it went around and around eventually getting absorbed by his heart, his liver and his pancreas getting in trouble everywhere it went.
Your son was fine when he got here.
It was your freaked-out over-protectiveness that nearly killed him.
Nearly? He's young.
A few weeks of dialysis, he should be fine.
You gave birth to a freak of nature doesn't mean it's a good idea to treat him like one.
How are you feeling? A little bit better.
I saw you talking to your parents earlier, that's good.
My mom asked if I wanted to take dance lessons.
That's great.
I'm actually worried I might miss basketball.
I was starting to get good.
No reason you can't do both.
Starting tomorrow, you'll come to my office for your fix.
I'm done with the methadone.
I screwed up.
The kid's parents wanted that MRI.
I knew he didn't need it.
I did it anyway.
That's what got him sick.
You just solved a case that no one else could solve.
I created a case.
I played nice because I was in a good mood because it didn't hurt.
You don't need your pain to be a good doctor.
I'm not interested in good.
You're afraid to be happy.
Why do you care if I'm happy? You're afraid of change.
The one thing you have is your intellect.
You think if that's compromised, you have nothing.
Just take it.
No.
Don't do this.
It's already done.
This is the only me you get.