House, M.D. s05e22 Episode Script

House.
House.
I know you're not asleep.
That insight would be a lot more impressive if you weren't just a product of my exhausted brain.
Aren't you curious about why I'm here? Curious why no French maid's outfit, no spanky pants I'm a hallucination, not a fantasy.
It's insomnia.
Four nights without REM sleep can cause That might explain why you're hallucinating doesn't explain why you're hallucinating Wilson's dead girlfriend.
Probably because of my secret and very unconscious desire to get Wilson into my bedroom.
Or maybe guilt over Kutner's suicide reminds you of how guilty you felt about me.
Who cares why you're here? A decent night's sleep and you won't be.
Guess I'll be around a few more hours.
Need some coffee? Addictive substances are no substitute for nature's healing balm.
Let's make this fast.
I need to sleep.
Deaf 14-year-old started hearing imaginary explosions.
Exploding head syndrome.
Cool.
Obviously his brain knows how to hear.
Patient went deaf at age four, complication of meningitis.
So, why no cochlear implant? Usual suspects are insomnia, which he doesn't have migraines, which he doesn't get and head trauma, which didn't show up on the CT.
Damn imaginary pen.
Mom's signature's on everything.
Did Dad die? No, I doubt it.
He was a sperm donor.
Medical records couldn't be cleaner.
So, we're left with temporal lobe seizure.
Wrong.
Someone at the wrestling meet would have noticed a seizure.
Could have just looked like a bad shot to the leg.
Put him in the seizure lab, see if his head blows up all over again.
You're gonna ignore your own subconscious? Gonna be the limp leading the blind.
I need a scrip for sleeping pills.
My neighbor's dog has been keeping me awake and it seems strangely invulnerable to poison.
Why is the soon-to-be- second-prettiest Dr.
Chase here? I'll take that as a "Congratulations.
" We're discussing a case.
Why did he close that file? Wedding in two weeks? I'd say you were pregnant but I don't think Chase's body is mature enough to produce sperm.
It's a small ceremony, why wait? Nighty-night.
Drugs with no lecture? He wants you out.
Interesting case? Possible prostate cancer came into the ER.
Pencil cup.
No wonder his prostate is enlarged.
It's full of pool cues and cigars.
Chase's best man doesn't get here till the day of the wedding so I asked Wilson to throw his bachelor party.
No retired ministers available to plan it? Chase doesn't want some big, raucous party.
So she says.
Luckily, there are people in this world ready to stand up for what's right.
No, no, no.
I don't want you to Listen, of the two things I do well, bachelor parties rank towards the top.
I get to help, right? Starting five hertz.
House made it through that entire differential without mocking our patient for not having a cochlear implant.
The patient doesn't want an implant because he's comfortable with who he is.
It's admirable.
He's deaf, that's not an identity, it's a disability.
It's also a culture.
The deaf have their own schools, their own language.
Still no spiking.
Going to 20.
Anything I can simulate with a $3 pair of ear plugs is not a culture.
No sign of seizure.
Temporal lobe activity is still clean.
Doctors.
Doctors, he can't see.
One of his eyes.
"The limp leading the blind.
" Is that supposed to mean something? I didn't think so.
So, exploding head syndrome plus vision loss.
Subclavian steal syndrome.
Vascular defect coupled with constant arm movement could siphon blood flow from the brain.
We should do an angio, check his Knock yourselves out.
How did I know he was gonna go blind? Don't get cute, Gazoo.
You're in my mind, you're obviously there.
C- Reactive protein.
I noticed in his file it was slightly elevated.
I figured the stress of the seizure lab would drive the inflammation even higher and lead to optic neuritis.
That's a lot clearer than "the limp leading the blind.
" It was just a glimmer.
I couldn't put it into words.
It was a long shot.
I don't even remember the C-reactive protein level.
Obviously you do, you just don't know it.
How high is K2? I don't know.
Me neither.
But I read a book about it years ago.
A fierce, sexy Sherpa on the cover, bending over to Cool.
An all-access pass to my own brain.
Go play the kid some music.
Why? Another long shot.
We're using iodine dye to track the blood flow in your neck and arm.
House, what are you doing? What's it look like I'm doing? Fighting the power.
Feel that? How cool is that? Apparently your mom doesn't care what you're missing.
You're an ass.
He says he feels the vibrations in his abdomen, but not his hand.
What does that mean? It's a new symptom.
Neuropathy.
Thought you were gonna get some sleep.
The case got interesting.
It's like the zoo.
Except you can bang on the glass as much as you want.
How'd you know about the neuropathy? Good question.
Enough with the riddles.
Tell me about it.
Think wrestling record.
Juggling.
No, pins, three pins.
Patient was pinned in his last three matches.
Leading up to that he was 15-and-0.
I figured his balance was off from diminished sensation.
Could be increased ICP from a brain tumor.
That we missed on the head CT? Cutting weight for wrestling could've led to rhabdomyolysis.
Patient went up a weight class three months ago.
Foreman's right.
Actually, increased ICP could make sense.
You just said I was processing.
It also puts a new symptom on the table.
His deafness.
What if it was caused by NF2 cancer, instead of his childhood meningitis? So, meningitis was a coincidence.
Or a by-product of the cancer suppressing his immune system.
MRI his head.
If you're right about NF2, his deafness may be reversible.
I'll set it up and talk to the patient.
You two doing anything? Do you know what a "Broken Cowboy" is? It was on House's list of requirements.
I have three theories.
Why is House so into this bachelor party? He needs to have a reason to be into a bachelor party? He needs a reason to be into anything.
Give me your wallet.
House could be trying to tempt Chase into cheating, break them up.
You think House is into Cameron? I think House is into Cameron being into him.
Marrying Chase would shatter that fantasy.
If Chase cheats, they shouldn't be getting married in the first place.
So, you're okay with House getting Chase smashed enough to make a stupid mistake? Being drunk doesn't change who you are, it just reveals it.
You think she can do the Broken Cowboy? God, I hope so.
NF2 is an extremely slow-growing cancer, which makes it very treatable.
If we're right, taking out the tumor means there's a chance you'll regain your hearing.
No, they said you have to.
What's wrong? He wants you to treat the cancer, but leave him deaf.
Sorry.
It doesn't work like that.
But why? I don't know.
Imaging shows slightly elevated ICP, but no masses on or around the nerves.
It's not cancer.
Slight bowing in the wall of the fourth ventricle, could still indicate a tumor.
We brought pictures.
The fact that you sent me on a scouting mission No skirts.
You're not on the guest list.
Bachelor parties are an ancient and sacred male rite of passage.
The ventricle bowing is most likely a pre-existing anatomical anomaly not the indication of a tumor.
No way to know for sure without a brain biopsy.
If I get drunk enough, there's a chance I might make out with one of the strippers.
Or become one.
Sold.
Sold.
We can't just drill into our patient's brain on a hunch.
God, not her.
God, not her.
She's the one that got me hooked in with Madoff.
Taub's right.
It's not cancer.
Yeah, by all means abandon a great diagnostic theory because it's difficult to prove.
Do a biopsy.
We need to take a better look at his fourth ventricle.
Or an older look.
The mom is never gonna let us touch his brain without some evidence.
Patient broke his nose years ago.
Hospital could've done an MRI.
Okay.
The main reason my third wife and I eloped was to avoid House's bachelor party.
Have you seen Caligula? My patient's brain now versus three years ago.
See any difference? Is he telling you to avoid the party? I took an oath to do no harm.
Sure, don't come if you want your wedding vows to be meaningless.
This should be interesting.
You are going to commit to that one special woman forever which is beautiful.
But if your commitment the day after the wedding is the same as your commitment the day before then the wedding meant nothing.
So, and I see no logical way around this, if you want your marriage to matter you have to be a wanton, trolling, muck-covered pig the day before.
You're evil.
See you.
The wall of the fourth ventricle changed, it isn't bowed in the older scan.
Evidence of NF2, right? You'd need to do a brain biopsy to confirm.
I'm not going to the bachelor party.
Every time I go to one of your parties I end up embarrassing myself in some new and unexpected way.
That whole thing with the duck was hardly unexpected.
I'm not going.
Okay.
It's not okay.
Do you know who we need? That stripper you got for Wilson's bachelor party.
You could do body shots right off her.
Why go back to that well? In the nine years since Wilson's party a whole new generation of hot girls have been abused by their stepfathers.
She loved cats.
Why would you remember that a stripper loved cats? Chase has a cat, they'll bond.
House, you entertaining yourself up there? Just rehearsing for the revival of Evita.
What did you find? Biopsy shows nerve inflammation consistent with increased intracranial pressure.
Something's wrong, but it's not cancer.
He's gonna go through life deaf.
He's okay with that.
He has no idea what he's missing.
His mom's a moron.
He's gonna pay for her stupidity for the rest of his life? Are we okay with that? Why are you closing? You're supposed to put in a cochlear implant.
That wasn't in the paperwork.
Really? Well, someone must have screwed up.
I'll go track it down.
I'll wait.
That's a great idea.
Let the kid spend more time under anesthesia with his skull cracked open.
I'll wait.
I've been known to lie to serve my own agenda.
An implant does absolutely nothing to help me diagnose him.
Let's get an implant tray in here.
Just try to relax.
Her son didn't want the implant.
If he still doesn't want it, after having time to adjust, I'll take it out.
I'll blind him, too, if he wants to experience that culture.
Remove it now.
Kid just had brain surgery.
He's not stable.
Ms.
Miller, I'm not trying to minimize Dr.
House's wrongdoing but the best thing for your son Why is she sitting? She's not yelling, not threatening, not pacing, just sitting.
Understand, Dr.
House? House, focus.
I need you to say you accept the arrangement.
No problem.
You're not mad.
I'm mad.
Not mad enough.
You wanted your son to hear.
You just didn't have the guts to make him get the implant.
Once my son is stable, I want that thing out of his head.
Why did you do this? Because he is ignorant and he's being raised by an idiot.
Not good enough, you always have My patient is opting into a handicap.
He's an insult to all the other gimps out there.
Okay.
But I'm still putting Foreman in charge of the case.
That's the arrangement? Okay.
You're okay with Foreman in charge? Who you calling? Oh, right, you don't want to look like a lunatic.
Yeah, about that.
You think we did the wrong thing? I'm not sure.
I'm not even sure why we did it.
That argument you made to Cuddy sounded pretty good.
To you, maybe.
Huh.
I figured by now you'd be at the board in your monocle and jodhpurs.
Yeah, you did something stupid.
Quick, better mock someone.
Why did you do it? Why did I give a human being the power of hearing? You can ask God the same question, he'll give you the same answer.
Patient has a fever now, too.
Probably just a post-op complication.
Arnold-Chiari? Not without muscle weakness.
Pseudotumor Cerebri? We checked his eyes before the surgery.
No papilledema.
Candy? I'm pretty sure Wilson's stripper's name was something sweet.
Maybe his fever is more than a post-op reaction.
His girlfriend was sick a few months ago, maybe her flu was really Epstein-Barr.
Lolly? - They swap spit virus travels to his brain, leads to meningitis leads to increased intracranial pressure.
I agree.
Taffy? I agree.
Go ahead, start him on ribavirin for Epstein-Barr.
Keep making decisions like that it really bolsters the illusion that you're in charge.
Why aren't you in my office? Because I know what the word "my" means.
I did something insane, and you're not all over me analyzing why.
It was nice.
I gave that idiot an implant to prove to him what an idiot he's been.
How is that nice? You didn't do it to solve the case, you didn't do it to save his life you did it to make his life better.
It was a caring act.
Which you did in a way that was immoral and illegal, but baby steps.
Doesn't sound like us.
You can't make me go to the bachelor party.
I know.
And you're okay with that? What choice do I have? Seth! Please, God Seth.
Yes.
Seth.
Oh! I think he just wet the bed.
Kid's dehydrated but stable.
Thankfully the fountain of whizz seems to have stopped for the moment.
Not before hosing Epstein-Barr off the table.
Now, eat up.
We're gonna pick out the ice cream flavors for the bachelor party.
Could be a systemic autoimmune disease.
This tastes like vodka.
Well, it would be stupid if it tasted like bourbon.
That's the brown one.
It is vodka? Flash frozen in a secret process.
Guy figured it out in his basement.
Limoncello.
Genius.
Symptoms came on too hard and too fast.
Sarcoidosis is progressive.
Remember, in med school, when Donovan gave grand rounds there was that guy who was peeing liters.
Glomerulonephritis.
Wrestler, steroids could have damaged the kidneys.
The scotch is nice.
His urine would've been brown.
Donovan ruled out osmotic diuresis, kidney disease Pheochromocytoma? No hypertension, plasma metanephrine is normal.
Devic's? It happened at night.
That was the clue.
Night, recumbent body position, changes in BP It's his heart.
Run a 12-lead EKG, watch him for four hours.
Foreman concurs.
What the hell just happened? Everything started to fade away.
You're getting better at focusing, ignoring everything that doesn't matter.
Uh-oh! He looks pissed.
I think he might hit us.
Is your eyesight better than mine? We need to talk about the bachelor party.
Excellent topic choice.
I mean, surgery is so boring, and my lying to you is just so yesterday.
It's my fault for letting you talk me into the implant.
Cameron is not gonna be happy about this party.
But, you, on the other hand Plan on spending the rest of my life with Cameron.
So, I need to cancel the fart band? So, I need you to kidnap me.
Spoken like a true Aussie.
By the way, if you know where I can get me the sheet music to Waltzing Matilda Hey! Want some ice cream? We're having a sundae bar.
Sweet.
That's her name! Sundae or Bar? Karamel.
With a "K.
" Bathroom? Down the hall, two doors, on your right.
Thanks.
Do I sound like her? It takes time.
You still haven't slept? And then I have a clever response.
EKG, normal sinus, normal intervals.
His heart's fine.
His heart's not fine.
The heart was fine during this test.
The arrhythmia's hiding.
Or we were wrong about the heart.
Could be the thyroid.
Hashimoto's would explain the kid's urine and brain pressure.
Treadmill.
Or the arrhythmia is hiding.
We need to stress him.
Put the patient on a treadmill.
The patient just had brain surgery.
A stress test could cause a brain bleed and kill him.
I value your opinion.
I value rejecting your opinion.
You're not doing this.
You haven't been sleeping Cuddy doesn't actually want you in charge.
She just wants to avoid a lawsuit and to win an NAACP award.
And if I let you risk our patient's life testing an organ we already tested we accomplish neither.
Run a thyroid panel.
How do we get him into the stress lab without Foreman's sign off? We could kill Foreman.
Is she new? Focus.
The lab simulates stress.
What if it's not simulated? We could tell him his girlfriend dumped him.
It's a tough sell since she never leaves the room for more than five minutes.
We could kill her.
Or asthma meds.
Force the heart to beat faster.
Revealing the arrhythmia.
Nice idea.
It was yours.
I just left the room for a few minutes.
He ripped out his implant.
So much for improving his life.
Actually, I think we just saved it.
Look at that.
Arrhythmia.
You were right about the heart.
I should have listened to you.
The correct phrasing would be, "I should always listen to you.
" He's got problems everywhere.
What goes everywhere? Blood.
Could be thrombocythemia.
Excess platelets lead to clotting throughout the body.
Not with a normal platelet count.
So the clotting doesn't start in the blood, it starts in the lungs.
Pulmonary embolism.
We should do a VIQ scan, see if his lungs are clear.
Go.
Are you sure I did this at Wilson's party? Last time, you used grain alcohol instead of the sambuca.
And it worked? Well, it explains my lack of eyebrows by the end of the evening.
By the power of Grayskull, I This is why we're rehearsing.
Ever wonder what's happening every time our patient gets sicker? Not right now.
First symptom, wrestling.
Then, under the lights of the seizure lab Are you going somewhere with this? Because this feels Just keep doing what you're doing.
It helps.
Then, under the stress of blindness, then, post-op fever.
What do all the symptoms have in common? Heat.
See, if you hadn't been here, that would've just popped into my head which actually would have been way cooler.
Foreman, kid's got Uhthoff phenomenon, which means it's MS.
Start him on double-dose interferon.
Let's get our drink on.
Not before I've added chemical burns to this guy's cause of death.
Patient's responding to interferon.
Looks like I can retire as department figurehead.
Dr.
Robert Chase? We're with the Department of Citizenship and Immigration.
Did you recently apply for a marriage license? Ah Yes.
According to our records, your work permit has expired.
If you could come with us? I'm his fiancée.
I can come along and clear this I'm sorry, ma'am.
Illegals only.
I'm sure it's a mistake.
I'll call you as soon as I know what's going on.
Don't let House get him in too much trouble.
Allow me to welcome you to the best night of your life.
Now, a few ground rules for the evening.
Safety is job one.
We have now gone 18 days without an injury in the workplace.
Yes, these girls are all working their way through law school, don't test them.
House! I knew you couldn't stay away.
This is my apartment! You can't do this.
Clearly reality begs to differ.
Where's my furniture? Out back somewhere.
James! Karamel? Hey.
How's your wife? We got divorced.
How's your cat? Dead.
How about we go have a drink? This way.
Okay.
You're okay with this? I paid 50 bucks for this.
You guys are great together.
Trust is everything.
I'm gonna get some air.
Keep it real.
You should be out there, enjoying the lap dances of your labors.
I kind of like it in here.
Me, too.
To us, figuring out MS.
And the blindness and neuropathy, and arrhythmia, and anything else we did.
What exactly did my team do? Looked good in their lab coats, except for Taub.
Some people just work better alone, so to speak.
One more drink.
No.
I can't.
I gotta take a break.
Meet Karamel.
Maybe one more drink.
What's that taste? Is that strawberry? House, you in there? Use the other bathroom.
It's in the kitchen, looks like a sink.
Chase went into anaphylactic shock from the stripper's body butter or something.
Is he okay? One of the residents had an EpiPen, so he's fine.
But we're taking him to the hospital to be safe.
Okay.
I knew that Chase was allergic to strawberries, didn't I? That's why you wanted Karamel at this party.
I suggested Karamel 'cause she was great at Wilson's party.
I knew about her body butter, I knew about his strawberry allergy.
I tried to kill Chase? Why would I do that? I don't want Cameron.
You're not a big fan of other people's happiness either.
Hello.
You confirm? Thanks.
That kid we saved, he's dying.
It's not MS.
We were wrong.
Thank God you're okay.
What happened? There was a girl Long story.
Your patient's lung failure rules out MS.
We put him on a ventilator.
Enlarged lymphs could Are any of you sober? Turn around, you need to go to the hospital.
I need to sleep.
I'm you.
You can't just shut a door.
You tried to kill Chase.
I need to push you back down, you're dangerous.
It's the hospital.
I'm not answering.
Hello.
I'm here with your team trying to sober them up so they can help treat your dying patient.
Foreman's dying patient.
What causes lung failure plus your patient's previous symptoms? Eosinophilic pneumonitis.
White blood cells accumulate, clog up the lungs, lead to heart problems.
It fits.
House, are you there? It's not eosinophilic pneumonitis.
I gotta crash.
House, don't hang up.
We need your help.
I can't.
We can solve this.
Good night.
Eosinophilic pneumonitis could actually make sense.
No, House ruled it out because it would affect the larynx.
Patient would be hoarse.
Which we wouldn't notice in a deaf kid who rarely speaks.
Wait.
Everyone's getting breath mints.
We need to hear Seth speak.
That means taking out the tube.
Isn't that dangerous? It's the safest way to confirm what's wrong with him.
I need him to breathe out once I pull on the tube.
Okay.
Say "ah.
" I'm sorry, we were wrong.
I need to suction out your throat before we re-intubate.
Your son smoke? I don't think so.
Tobacco stains on his teeth.
He says he used to chew tobacco to cut weight for wrestling.
Used to? Chewing tobacco wouldn't explain his symptoms.
But not chewing tobacco might.
Taub was right.
It's sarcoidosis.
The tobacco releases toxins, those toxins suppressed his immune system.
Once he quit chewing the absence of those toxins kicked a dormant condition into hyper-drive.
Is it treatable? Usually responds to corticosteroids and methotrexate.
I'll start the meds.
I need sleeping pills.
I was gonna hit up Wilson, but he's not answering his phone.
He must have left it in his pants which he wasn't wearing when the police found him trying to walk home, oddly from his own apartment.
Pills.
Your patient is doing fine, thanks to your team.
It wasn't eosinophilic pneumonitis, was it? Sarcoidosis.
Good.
House, please, talk to me.
I haven't slept through the night since Kutner killed himself.
The wrestling might have to wait.
I'm gonna tell your doctors to repair your implant.
I know.
And then you ripped it out rather than live with it for a few days even.
I'm your mother.
This is my call.
I don't know if I'm making the right one, but it's mine to make.
Sleep well?