House, M.D. s05e18 Episode Script

You have a patient waiting.
See? I'm waiting for a follow-up.
If you're talking about Mr.
Casdin he has a deceased sticker on his file as do all the other follow-ups you have scheduled for today.
Whoops! I had colds all winter.
I've been in this room a while, but it's spring now, right? I feel run down, like maybe something big is coming on.
Run down? Come on, give me something.
Sore throat? No.
Runny nose? No.
I know it sounds weird, I'm a nurse but could you run maybe a CBC or a thyroid Dr.
Cuddy, need a consult! Until she stops seizing may as well go back to my office and get my diagnosis on.
She's urinating on herself.
She's having a seizure.
If she hadn't peed It's green.
Interesting.
Thirty-five-year-old woman.
Head of nursing in an old-age home.
Neurological symptoms and "P"? Oh, green pee.
I get it.
Nice.
Neuro is also written in green.
Does that mean she has green neurological symptoms as well? From now on, I'm gonna use two colors.
Green indicates irony.
Pseudomonas infection.
She'd have a fever.
Toxins? Why are we taking this case? Welcome, Your Lordship, we were just preparing your morning briefing.
Sorry I'm late and, yes, green pee does meet the only diagnostic requirement you care about.
It's interesting.
But is it worth us taking this case? "Us" aren't taking anything.
I'm taking.
You're accepting.
Okay, I accept.
She has adult-onset epilepsy and she really likes those St.
Patrick's Day beers.
Go check out the house and the office for toxins and infections.
Her neuro exam was normal, no subsequent seizures.
It's not life threatening.
It's not important.
Luckily, neither are you.
You okay? Fine.
You and House this morning? The way you were arguing? Airing disagreements doesn't qualify as arguing.
Come on, man, I'm just trying to help.
We're friends.
There are 400 Japanese teenagers you were playing Halo with last night you're better friends with.
Your avatar should ask their avatars how they're doing.
I consider you a good friend even if we don't hang that much outside of work.
I wasn't arguing with him.
You kind of were.
Fine, I was.
And you know what? I was right.
You got conned.
Methylthioninium chloride.
Notable side effect, green urine.
She's a nurse, she knows the dosage knows how to fake a seizure.
She pees pea soup and gets the warm attention of doctors all week long.
She's a Munchausen, and you're her mark.
So your insight is based on discovering an anti-Alzheimer's drug at an old-age home.
No good reason it'd be sitting on her desk.
You ever tried to pee on yourself in public? It's not easy.
Sorry, I rushed the Jewish frat, we peed in private.
For good reason.
I can spot a fake seizure which means this was real, which means her problem is phenol.
Carbolic acid? Yeah, maybe she accidentally inhaled some at a gout treatment facility, circa 1890.
It's still in some antiseptic throat sprays.
She's been chugging it all winter for her colds.
Phenol explains the seizure and the urine.
She'd have to drink five bottles a day.
Which is why I'm sure you won't have trouble discovering the evidence of it when you search her house.
Bye.
And you can start her on charcoal hemoperfusion for the phenol poisoning.
Seriously? Oh, you were lying about the throat spray.
That does make more sense.
So why are you wasting Taub's time? Because I don't want him to know that I'm wasting my time disproving his fake seizure theory.
Zip! Chris? Chris Taub, right? Neil Zane.
I was two years under you at Collegiate High, remember? Sure.
So you are some big doctor here now? I'm a doctor.
You? I was speaking at an econ course over at the university.
I tripped and banged my leg.
I have some time.
Come with me.
Hi.
Tests back? Head CT was negative.
What about a thyroid uptake or abdominal ultrasound? Sure.
How about I flash some lights in front of your face first? You want me to have another seizure? We're gonna have to give up the room unless we can confirm a problem.
Okay.
Damn it! Oh, God.
Please forgive me.
I'm so sorry.
What are you worried about? You'll have maybe a night in jail for fraud.
I have to go tell one of my employees he was right.
I'm not a Munchausen.
I'm gonna die unless you help me.
You'll have to come up with something more original.
A cat predicted my death.
Cats make terrible doctors.
Oh, no, wait, that's women.
You're screwed.
How'd you slip? I've had this dizziness problem for a while now.
You get checked for labyrinthitis? On antibiotics for a week.
No difference.
Lie down a sec.
Whoa, whoa, I'm dizzy.
That's normal.
So what are you teaching? Entrepreneurship.
I'm a CEO.
OstTech Industries.
We make medical devices.
All right.
You can sit up.
So, did that tell you anything? Did I Oh, my God.
You just cured me.
I figured you had a tiny calcium deposit in your inner ear.
I just shifted it around.
I've seen three doctors for this.
I'm buying you dinner.
Forget it.
Come on.
I'm also an investor in a club, we'll make it a night out.
Well, I'm married, boring.
I know some married people who aren't boring.
A few years back, I was one of them.
Good luck, Neil.
If you're gonna kill me and rape me, please do it in that order.
This is the cat.
Debbie.
Have you heard of her? Debbie? Sorry, but without a last name She was on the news.
We found her as a kitten.
She lives in the nursing home.
She only sleeps next to people when they're about to die.
Ten patients in the last year.
And then yesterday, she did it to me while I was sitting on my couch.
Please.
The whole staff, the doctors even, we all know this is real.
Can you come back later? I have some business I'm conducting with the Prince of Nigeria.
Just watch this video.
It'll prove I'm not lying.
Dr.
House, I am begging you.
Chest.
Quick, before she goes without attention for eight seconds.
House.
She's faking.
The cat told me.
Listen.
Soft breath sounds.
Means it's bronchospasm.
You can't fake that.
Debbie the cat spends most of her time just prowling the halls the queen of her own private world.
- I gotta say I don't think the changes they've made to American Idol really work for me.
When Debbie climbs on a patient's bed and goes to sleep we call the loved ones and tell them to come in.
You wanna treat her? She's a nut job.
Don't we all have quirks? Aren't those eccentricities what make us human? It's like Debbie's here on Earth to bring people to the other side.
The doctors that we spoke to also agree that the cat Nut jobs get sick, too.
So you think this cat story is nonsense and you admit she faked her earlier symptoms but you still think she's actually sick now? Well, anything would sound ridiculous if you said it in that voice.
Confirm she's faking or I'm gonna have to kick her out.
There's that voice again.
I'll give you 24 hours.
Consecutive? What are you doing? No, Mr.
Bond, I expect you to die.
Bronchospasm.
Go.
Bronchitis.
No cough, no fever and Blofeld didn't smoke a cigar.
He might have.
Dude had a lair, means he was rich.
Rich people enjoy a good stogie, sometimes send them as gifts.
Hey, Taub, did that sound like I was awkwardly trying to segue into making a point? Yes.
Emphysema.
Lungs were clean on the CT.
Dogs can be trained to predict diabetic comas, epileptic seizures they can smell cancer.
It is possible there's something to this cat.
It's more possible it was just a coincidence.
Ten million nursing homes, hundred million pet cats one of them was bound to pick a few winners.
Debbie was able to predict there was something wrong with the patient before you were.
Is that a coincidence, too? Maybe the cat didn't predict anything, it might have caused the deaths.
We should've listened to Ted Nugent.
Yeah.
It could be cat scratch fever, or visceral larva migrans.
Maybe it didn't kill everyone at the nursing home but it may be killing Morgan.
The worms hop from the cat to the cat lady's lungs.
I could buy that.
Those cigars were for me.
Hey, that reminds me.
Why is some fancy CEO sending you a box of Cuban cigars? Is it related to your money worries? What money worries? Extrapolating from the fact that he's been skipping his morning muffin I'd say that he lost almost all his money in the market last year.
I'm on a diet.
I'm also extrapolating from the online portfolio you forgot to log off but it's mostly the muffins.
Scope her for worms in the lungs.
We could help out in there.
Yeah, it takes at least four people to look inside a crazy woman's lungs for imaginary worms.
So, you're in a good mood again.
Do you need another speech about what a great friend I am? I'm telling my wife we don't need to downsize but maybe we do.
You really lost all that money? I don't care about the money, I just feel bad for Rachel.
She married a guy in one situation, ended up with another.
That's hard on anyone.
Thanks makes me feel much better, hearing my wife's a gold digger.
No, I just meant she married this master-of-the-universe successful surgeon and now he's basically a flunky for this mad scientist who saves lives, so that's good.
There are no worms in the lungs.
What else could cause bronchospasm? Severe acid reflux.
No esophagitis, it's not reflux.
Why are you pushing a crash cart? Because patients sometimes crash, and they haven't yet invented a crash tractor for me to drive wildly around the hallways.
Why are we in the coma patients' room? You actually think the cat is going to predict someone's death? No.
I know the cat is not going to predict anyone's death.
And then I will have scientifically disproved You didn't keep this patient despite the cat you kept this patient because of the cat.
You're scared there's something to it.
If I could prove the non-existence of an omniscient God who lovingly guides us to the other side, I would.
Cat version will have to do.
Are you scared? Cats' brains are always in alpha mode.
The few scientific tests that have seemed to confirm psychic phenomena that's where it takes place.
Please tell me that you were kidding, so I won't have to fire you.
I was kidding.
We still have a human patient, right? Airborne allergens possible? Skin test was negative.
Lungs may be more sensitive.
Or House just screwed up.
If you misinterpreted the breath sounds as soft instead of loud it's laryngospasm instead of bronchospasm.
Which she can get from a simple panic attack which she was having.
I also heard the lung sounds, too, Taub.
You saying I screwed up? "Screwed up" is maybe too harsh, but yes.
Don't you wanna check their charts? Of course not, this is a double-blind.
I don't want to even subconsciously signal to Teddy which one's the sickest.
Her name's Debbie.
Are those welts on that guy's arm? Were they here when we got here? He has a severe cat allergy.
That never happened.
Look at Debbie.
Good news, Mr.
Limpert.
When you don't die tonight you will finally have done something good for the world as opposed to your life as a fireman.
Foreman's airborne allergen theory makes the most sense.
Do a methacholine challenge on Catgirl to check it out.
I told you to get rid of Death Cat.
You see a cat? I see a litter box.
This is a disability, Dr.
Cuddy.
I can't make it to the men's room You pee on the mice, too? Well, now, you see, the mice actually prove that I don't have a cat.
Are these Are these the genetically modified lab mice from oncology? Genetically modified for tastiness.
Get rid of the cat, and get rid of your patient.
My team is doing a methacholine challenge.
Your team just completed a methacholine challenge which came up negative.
Who told you about the test? Taub? I'll never say.
But yes.
Her airway's clamped down.
I heard it.
We kick her onto the streets, it could happen again.
Wish there was a "lawsuit cat," it could warn you.
I'm sorry, but if you won't escort her out I'll have to get security to do it.
You're joining me for a goodbye smoke.
I don't smoke.
Fine, if you don't want the seventh graders to think you're cool.
I went through your purse.
Horoscopes, good-luck charms.
You went to a good college, good nursing school so you weren't always a superstitious idiot.
I'm not a superstitious How about four years, that sound right? That's when you switched from the family insurance plan to the one you're on now.
I was married, I got divorced.
Two years before that, you got chickenpox shots which you only get in adulthood when you have a kid.
Or I should say when you had a kid because no kid has come to visit you.
Which all makes me think something bad happened.
It was my stepson, Timothy.
What happened? He was in school.
He was having his morning snack, and he choked.
And the teachers saw it, and they did everything that they were supposed to.
He shouldn't have died.
You wanna make it make sense.
What's wrong with that? It's meaningless is what's wrong.
What's wrong is that it doesn't do a thing to bring your kid back or put you and your ex together again.
Rash on your neck.
Probably not enough for Cuddy.
Can't breathe.
Hey, Doc.
Breath sound soft to you, Doc? Hooray, you're officially sick.
Churg-Strauss fits best.
Here's the plan.
Taub, change the litter box.
This is pathetic.
You're still punishing me for calling you out on the green urine lady? Nope, this is for ratting me out to Cuddy.
I'm not asking you to apologize, just scoop some poop out of a box.
Just clean it.
Let House do it.
Yeah, that'll happen.
He won't just continue to let our room smell like cat pee.
I'll clean it next time.
I'm out of here.
Now that you've delivered that important lesson, I'm gonna go test the patient.
Whoa! What, you think your bag's going to die now? Now you're punishing me because you think I'm superstitious? What do you care? It's not so much about me caring, per se it's more about me wondering why you're such a credulous idiot.
Thirteen, start the patient on steroids for the Churg-Strauss.
Unless we have something we need to argue about? This is good stuff.
The best.
It's made from the distilled sweat of recently-laid-off hedge fund managers.
Aren't you happy you came out tonight? Yeah.
I wasn't actually going to, but not the greatest day at work.
I used to have an office like this.
Used to? When I was a plastic surgeon.
But one day, I took stock of my life and Oh, screw it.
I had an affair with the daughter of one of my partners.
They signed a non-disclosure, I signed a non-compete.
And the funny thing is I wound up telling my wife anyway.
You like your job? Same as you, same as everyone, it has its ups and downs.
You're lying to make me feel better.
Yeah.
It's the best.
I'm in charge, you know.
I'm a kid with toys.
Speaking of which, what do you think of the prototype? It's amazing.
You gotta make it a half-inch smaller, though.
You serious? I got small hands like women surgeons which are your fastest-growing market.
Me and the girls would have to use two hands to hit the switch.
Why do I bother paying the idiots that work for me? Put down that crap you're drinking because I am breaking out the really good stuff.
What's wrong? I went to the bathroom.
My urine Green again? It's brown.
I didn't do anything.
Honest.
I'm just a girl who can't say no It is possible she's still faking.
She didn't fake the bronchospasm.
You think she's faking some stuff, but not other stuff? Maybe she's Unchausen? I'm just saying the brown urine doesn't make sense.
What? Nothing.
We've ruled out every possible cause for brown urine.
No blood in the urine, liver and kidneys fine.
Brown could be fecal.
Fistula.
We checked.
How do we know the urine is still brown? Had to be.
Once you've gone brown If we've ruled out everything that can make the urine brown what if it just looked brown.
If the green dye never left her system, what plus green makes brown? Purple.
Strep bovis infection from colon cancer.
Paraneoplastic syndrome would explain the bronchospasm.
We scoped her when we checked for the fistula there's no tumor.
Oh, no.
I wasn't scared by the umbrella, either.
What? Not everything's about you, Kutner.
I realize it's stupid.
I just don't know everything I don't want to invite Great.
I thought your superstitiousness had to do with your folks being killed but "you're stupid" works just as well.
Why is there a ladder here? Whoops.
Forgot that one.
Scopes don't work as well as pillcams.
Give her one, find the tumor.
Come with me, Tiny Taub.
Sorry, I was late again.
I've got a long commute from the poorhouse.
Knew it when I hired you.
You'd eventually miss the money being the big shot like your new CEO friend if that nightclub stamp on your hand is any indication.
Don't worry, I'm not quitting.
I know.
A guy who signs a non-compete instead of just telling his wife that he cheated doesn't have the guts to quit.
Bad example.
I did tell her.
From guilt, not from courage.
And bravely running to Cuddy behind my back and arriving heroically late every day.
Cowards make lousy employees.
Well, maybe you're a coward, maybe you're quitting.
Either way, I'm screwed.
You'll note how Faster, Pussycat! Kill! Kill! Has snuggled up by coma guy over there.
More importantly, she did yesterday as well.
And he's still breathing.
We done? Thank you for showing me this.
But maybe she's just confused in this new environment.
In 1844, a preacher in upstate New York added up some dates in the Bible and predicted Jesus' return.
His followers gave away all their possessions and showed up in a field.
Guess who didn't show.
So the preacher said that he miscalculated and they went right back the next month but with more followers.
Every time he was irrefutably proved wrong it redoubled everyone's belief.
I know I sound just like them.
But I also know you're wrong.
Something terrible is gonna happen to me.
You trying to prove to her she's not dying? That would be dumb, as she might be dying.
This woman lost her kid.
Why are you attacking beliefs that give her a little bit of comfort? I don't care if her superstitions make her feel better.
I just want her to think more clearly.
Oh.
Maybe that can make her as happy as you are.
Where are we going? Experimenting.
Stop it, Dr.
Wilson.
It's just not cute anymore.
You already experimented on the coma guy.
Haven't you proved your point? Not to the patient and not to the millions of idiots who drooled over that news item about the magic cat.
Why are you so obsessed with this? Can't you just call her an idiot and leave everyone alone? Hey, look, kids, therapy cat.
You're a liar.
Therapy animals are dogs, not cats.
Aren't you feisty? This one's special.
If she likes you, interesting stuff happens.
No.
Okay.
Kids, playtime's over.
You know what, this is a good thing.
Because either you're starting to doubt yourself which is healthy, or I don't believe in the legend of Goodbye Kitty.
Or you're starting to give a crap what other people think Which is just another way of saying you give a crap about other people.
I'd love to hear more of your theory, but I don't give a crap.
Also, the pillcam's back.
Polypoid.
Raised edges.
Raised edges are actually necessary since that's the opening to the appendix.
How many times are we gonna watch this? There's no tumor.
Oh, my God the Death Cat is attacking your legs, you're gonna die.
Maybe it has something to do with that little red dot dancing around down there.
Oh, my God, the death laser is attacking your legs, you're gonna die.
We're wasting time looking for cancer.
She's still walking around, she's still pretty healthy maybe it's something minor.
Maybe we're not wasting time.
We wouldn't have seen a flat lesion.
Skin cancer could have metastasized to the intestines.
Cool.
Check for melanomas.
Here, kitty, kitty, kitty.
Come here.
Here, kitty.
What? - It's not cancer.
We found spider veins on her back.
They weren't there when she came in.
Spider veins means Cushing's.
Could cause an abdominal disturbance, brown urine.
But the bronchospasm? Cushing's myopathy.
It's uncommon, but Wait a second.
You didn't wake me up to tell me a symptom that's not killing her.
What else is going on? I think she's dying.
I just told you, it's Cushing's.
We treat I don't mean because of the spider veins.
Mr.
Limpert died.
If that's my high school gym teacher It's your coma patient.
He was stable for a year-and-a-half, and he just died.
The cat was right, House.
Here, puss, puss, puss, puss, puss.
Say "puss" one more time.
It's the sixth "puss" that really does it.
You're right.
Sulking will solve everything.
That cat sat on my lap, and that cat knows something.
You believe it now? Yesterday, it was all a coincidence.
Yesterday, it was, till I unintentionally proved it wasn't.
Patient must have Cushing's.
We have to figure out whether it's based in A cat's nose is powerful, could smell liver or kidney failure.
Exactly.
Except that if you'd glanced at the nursing home files I had faxed over this morning you'd know that most of the patients' livers and kidneys were fine.
What else? The MRIs aren't telling us if the Cushing's is in her adrenals or her brain.
So check her ACTH.
The cat's vision is at the blue end of the spectrum.
ACTH is 11.
7.
It's too close to tell.
And we can't treat the wrong organ 'cause that won't solve anything.
She could have a cortisol storm, could kill her.
Well, maybe, as the senior fellow, you could have made sure that my doors were closed so that I could be concentrating on the cat instead of looking for the cat.
You all right? Your nose.
What'd he say? Sounds like he said, "Do you like cranberry juice?" Crap.
Cheaper than fake blood.
And more cran-tastic.
Don't ever leave my door open like that again.
You're playing pranks and this woman could be dying.
So have Chase do a venous sampling in her brain.
If he finds something, it's there if he finds nothing, it's the adrenals.
I'm not who I used to be.
I'm scared.
It's not a way to live.
I wanna come work for you.
Jeez, Chris, you didn't think I didn't mean to imply that I could hire you right now.
You said you needed guys like me.
I know, but you don't have an MBA and I just hired a Chief Medical Officer.
Then let me invest in that laser scalpel start-up.
I got money saved, not a ton, but We put in a two-million-dollar minimum for the first round of financing.
Look I guess I could take you on, on a smaller number but you have to understand it wouldn't be some quick payoff.
Yeah, I know.
I know it's not gonna change my life overnight.
I just need to start changing it.
Okay, then.
Let's start.
What exactly are you hoping to find inside your dead coma guy? Catnip, chew toy I don't know, that's why I'm looking.
Your patient had a cardiac arrest during the venous sampling.
We got her back, but her heart's still tenuous.
That tell us anything? She's weak, possibly dying.
So nothing.
What about the ACTH? Slightly elevated.
It confirms the Cushing's is in the brain.
Go.
Are you sure that it's Cushing's? You'd expect central body obesity, she's in good shape.
If it had a normal presentation, there wouldn't be a cat involved.
So it's the brain means the next question is whether to remove her pituitary right now That's not a question for me, that's a question for the patient.
Now present both sides, let her decide.
All right.
I've got to stop telling you my theories.
You always just try to prove me wrong.
You mean the theory about Cuddy's ass getting bigger at the full moon? I confirmed that one, photo's on my blog.
Normally, you'd be up in the patient room hectoring her on what to do instead you're up to your elbows in some irrelevant dead guy who may or may not be connected to a magic cat because you want to prove to me that you don't care.
Case is over.
I'm exploring a scientific mystery.
I put up with your obsessions I even encourage them, for one reason they save lives.
I don't know what you're doing now.
Cushing's means your body is overproducing a hormone called cortisol.
The recommended course of action is to suppress it with drugs.
And that will cure it? Just treat it.
It could come back.
The only permanent solution is to cut into your brain and remove your pituitary gland but surgery's dangerous.
Your heart stopped on the table once already.
I want the surgery.
This thing is gonna kill me if I don't kill it first.
Because of the cat? Do you wanna tell me what an idiot I'm being? No.
I really believe that there are things that science can't understand that there is a role for faith and prayer, but it's in the waiting room not the OR.
There's a reason I got sick.
There's a reason for all the bad things that have happened to me.
I don't know what that reason is, but I know that if there isn't one if there's no greater purpose in the world then it's not a world I wanna live in.
I'll schedule an operating room.
You're early.
I'm not staying long.
I'm quitting.
You got a new job? No.
Well, then you're not quitting.
I'll see you back here tomorrow.
You're not accepting my resignation? Easier this way.
It avoids the whole thing where you panic, run back and grovel and I punish you, and then take you back.
Bye.
Bring donuts.
Everyone loves those bear claws.
Here, puss, puss, puss, puss, puss.
Puss? Mr.
Taub? I've been waiting 15 minutes.
Where's Neil? Neil doesn't work here anymore.
But he's the CEO.
I'm sorry.
I wish I could help you.
Sorry.
This is crazy.
I'm investing with his company.
He doesn't have a company.
He worked here, but he was a receptionist, a temp.
Where is he? He's in custody.
I really am not supposed to say anything else.
I went to high school with him.
That's what everyone else thought, too.
I'm guessing you also cured his ear problem? Did you give him the money yet? No.
I was right and more satisfyingly, you were wrong.
It was coincidence.
That cat was not predicting deaths it was just trying to keep warm.
Yes, dead people are renowned for their warm glow.
They are if they're feverish like three of the patients were.
Or if they are wasting away, like the other eight.
Wasting doesn't It does if it means someone sticks a heating blanket on you.
Congrats.
Because of your crazy obsession with this cat you've solved a completely trivial mystery.
Completely trivial? My God, it's clearly only partially trivial.
Debbie climbed on Morgan, too which means she was overheated.
So what causes flushing, mimics every Cushing's symptom except central body obesity? Cancer.
A corticotropin-producing carcinoid tumor of the intestine.
But your pillcam didn't find anything.
Means it must be somewhere the pillcam couldn't go.
The appendix.
Congratulations.
You probably saved her life.
You definitely saved her needless surgery.
Yes, I did.
What's the OR extension number? Just curious.
Thank you.
I wouldn't come here for thanks, that would be ungracious.
It's more about gloating.
You were about to cut out a piece of your brain just to chase some crazy superstition.
But I didn't.
You didn't didn't do anything.
I stopped it.
And what made you do that? Science.
Logic.
Reason.
Pick any three.
A cat chooses that exact moment to sit on your computer.
Maybe that's science and logic and reason or maybe it's something else.
You're an idiot.
I looked up the preacher from New York State.
His followers never faded out.
They became the Seventh-Day Adventists.
A major religion.
That man changed the course of history.
Because his followers were as deluded as he was.
Maybe he just gave them something to live for.
Feel better.
Kutner! Cat pee on my chair? Blood on my face? Fake blood.
You pay for the dry-cleaning.
Why are you still alive? I'm not sure.
I guess he was impressed you stood up to him.
And got a cat to pee on his chair.
Yeah.
A cat.
See you tomorrow.
Yeah.