House, M.D. s06e09 Episode Script

How the You know, most people go for the hardwood or carpeting.
I think guitars and garbage work just as well.
Got the urge to play last night, had to go all the way back to my apartment.
Thought I'd save on future trips.
Hmm.
That's very eco-friendly of you.
How about keeping down on the noise pollution? be flossing by now.
I'm not going to work today.
I'm going hunting.
After I sleep in.
Is it that time of year again? He's a self-important jerk.
He's my friend.
He's a self-important jerk.
Seems to be what I'm attracted to.
Guy calls you Jim.
Doesn't even know your name.
Jim is short for James.
Now go away, Lim.
Nice shot, Jim.
Oh, yeah.
Oh, yeah.
I nailed that tree.
Maple syrup for dinner.
We should have got a guide.
Doesn't count as a new adventure if you have someone holding your hand.
On the other hand, we are holding weapons and have no idea what we're doing.
Fun.
We need to sneak up on them.
I read somewhere that the Native Americans say turkeys know what you're thinking.
So I should stop thinking about German porn.
No, no.
That'll lure them closer.
We're terrible at this.
Yeah.
Well, at least it's cold and my new boots leak.
It's almost time anyway.
Did you bring the bag? May 30th, 2004, Dr.
Wilson informed me that if treatment didn't go well, my leukemia would give me only six more months to live.
November 30th, 2004, six months later, I didn't die.
As long as I am alive, I will find new and exciting ways to thank you for giving me another year.
Now move very, very far away from there, so that I can be sure and thank you again next year.
Thanks, Jim.
All right.
Let's see how many more turkeys we can miss.
Yeah, this'll work.
What the hell? God, sorry.
I don't know what happened.
I can't move my arm.
Am I having a stroke? I don't know.
Good news.
Head CT doesn't show any signs of a stroke.
So he's gonna be okay, right? I cannot believe how much you've grown up in five years.
She's She's not Emily.
Ashley.
My girlfriend.
New life, new adventures.
Ashley, meet Jim.
It's good to meet you.
So this arm thing, does that mean his leukemia's back? I checked blood counts and blood cell morphologies.
Everything is normal.
So these blood tests, that means it's not cancer for sure? He said I'm fine.
So what do you think it is? Hopefully something innocuous.
There's a doctor I can speak to who's great Who's great at diagnosing What? Sorry, that cold sore.
How long have you had that? Um, two weeks.
I'm sorry.
I got the call, I didn't have time to cover it up.
What is it, Jim? That cold sore is caused by a virus.
Assuming you guys kiss, the virus could transfer, infect your spine and cause the paralysis.
It's a disease called Transverse Myelitis.
And is that good news or bad news? It's great news.
I'll get you a room and start you on acyclovir.
I just had a House moment.
Diagnosed Transverse Myelitis from a cold sore.
How cool is that? Patients really eat that crap up.
It's why I'm loved.
What am I doing here? Ultrasound is clear.
Which means he's definitely not pregnant, right? No gall stones.
Could be diverticulitis.
Have you eaten any seeds? I'm joining you, Antonio Aguilar.
We'll play in God's Mariachi band.
Draw some blood.
The self-important jerk does not have Transverse Myelitis.
He's got cancer.
How do you even Okay.
Maybe I paid the redhead down in records a few bucks to CC me on all your cases.
A few patients die, you might get sad again, make a speech that would end your career.
Frankly, I'm stalking you for you.
How long does a simple blood draw take? Almost finished.
Well, when you're finished almost finishing it, test it.
My stomach was ripped open by the hand of God.
He spilled my blood.
Confusion.
Delirium.
Why rule out the hand of God so fast? Your guy's low white count and right arm paralysis equals a recurrence of his leukemia.
Simple math.
Did you look past the first page of the file? No AML cells anywhere.
I did the blood smears myself.
It's still cancer.
You know how I know? He's got an oncologist for a doctor.
And your magical leukemia detector is more powerful than a flow cytometer? I look for zebras because other doctors rule out all the horses.
In this case, you are those other doctors.
You haven't earned a zebra.
Hundred bucks.
Are you serious? Look, friends don't diagnose friends with cancer.
I get it.
Your problem is you're not objective.
Your caring is clouding your diagnosis.
If you just cut that out, you could be a pretty decent doctor.
Just give me the lactic acid level.
Twenty-seven.
The fact that you can't speak English is not an excuse for you not being humiliated by what I'm about to say.
It's also not an excuse for you not telling us that you were a tennis pro.
If you had, we wouldn't have wasted our time.
Fine.
Hundred bucks.
Tucker settling in? Yep.
Already got his first dose of acyclovir.
And don't worry, I ordered his girlfriend the kiddie meal.
Next patient on deck.
Del Clinton, day six of chemo.
You just missed the grandkids.
Oh.
That's all right.
Last time they were here, they painted my tie.
You're almost ready to go home.
You feeling okay? I feel like I felt after the last four rounds.
In oncology, familiar pain means all is well.
So that's good, right? Yeah.
I heard Jesse and Zeke were by earlier.
Yeah.
I'm sorry, Del, I gotta run.
How are they doing? They're fine.
No game-winning hits? No aced report cards? No school plays? I guess not.
I thought you had to go.
Are you depressed? I have cancer.
You've had cancer for a long time, and it's never stopped you from bragging about the grandkids.
Oh.
I guess I'm feeling a little more down than usual.
Can you give me something? Yeah.
I don't want you to get alarmed, but sometimes depression can be a sign that something else is going on.
I'm just gonna order a couple of extra tests, okay? What's going on? It's his foot now.
It's nothing.
It's not nothing.
I just started getting a little tingling feeling in my foot.
Is that bad? Ashley, it's gonna be okay.
It might mean his foot fell asleep.
It might mean nothing.
Can you give us a few minutes? Why can't you tell me? Because you're making him nervous.
Just give us a few minutes, okay, hon? Does this mean that it's not the disease you thought it was? It means the medicine I gave you is not working.
I just might have to hit it harder.
I'm going to add ribavirin to your treatment.
Jim.
Are you sure that this isn't a recurrence? So the brave face is just for Ashley.
She's young and she's terrified.
She's not really equipped.
Don't worry.
Once you've had cancer, recurrence is your biggest fear.
I get it.
I've looked at this thing every which way there is.
That's not what's happening here.
Can you call my daughter and ask her to come down? You can't do it? She hasn't exactly been talking to me since I got together with Ashley.
I'd really like her to be here.
Of course.
Exactly how serious does it have to be to justify you coming to see your father? No, I'm sorry.
I'd rather you regretted coming than regretted not coming.
Thanks, Emily.
How's Tucker? Well, he's made a mess of his personal life, but physically I think he's going to be fine.
Transverse Myelitis.
What does House think? What is this? Is House my overseer now? No, it's just not always a good idea for doctors to treat their friends, that's all.
Well, House has got So unless you want in on the action Um, is Bonnie still a realtor? As far as I know.
Do you mind if I call her? I'm looking for a new place.
I'm moving in with Lucas.
It wasn't the tennis.
You're moving in with Lucas? Yes.
You're Bonnie's friend, you know how to reach her, and yet, instead of calling her, you come and seek my permission.
You want my blessing, and, implicitly, House's blessing.
I don't need House's blessing.
Good.
So when will he be able to move his arm again? Should be soon.
You started smoking again? No.
What does that mean? Is it bad that he's coughing? Hi, Dad.
Hey.
Melissa, hey.
I didn't know you were coming.
I was at Mom's house when Dr.
Wilson called.
I can go if it's gonna be weird.
No, no.
Stay, it's fine.
Hi.
How are you? Is he okay? Yeah, he's okay.
I'm not a big fan of his coughing, though.
You must be Ashley.
Hi.
Hey, are you okay? Do you think this cold sore thing could've caused this? No.
Whatever is causing this is affecting more than his nerves.
I need a crash cart in here.
Don't you guys have a dying Mexican crooner to attend to? He isn't dying any more.
Found out he was on a popcorn diet, eating 10 bags of microwave popcorn a day.
Huffing the fumes scarred his lungs.
Wow.
That's very strange.
Where's House? Performing his ritual "hiding from Cuddy "to avoid getting a new case" dance.
It's sort of a jazz-fusion type of thing.
He's probably eating lunch in the morgue.
I can page him to your office if you want.
Actually, maybe it would be better if I talk to you guys alone.
House and I have a bet about one of my patients.
You guys mind making him Forty-three-year-old male in remission from leukemia, presents with left-arm paralysis and trouble breathing.
I assume House's money is on cancer.
Thanks, that's very helpful.
Subdural hematoma would explain CT ruled it out.
I thought it was TM, so I started him on anti-virals.
But he got worse.
Bacterial infection? Bacteria would move much faster than this, he'd be dead already.
It could be fungal.
A fungal infection would explain his breathing problem, but not his "unable to move his arm" problem.
Actually, if aspergillus fungus balls took root in his lungs and spread to his spine, it would explain both.
Thanks.
The treatment involves riddling the infected area with BB-sized pellets of anti-fungal meds.
I assume you don't just load up the 12 gauge and pepper me with birdshot.
No, we have a slightly more humane delivery system.
But we do have to open you up.
It is surgery.
And like any operation, there are risks.
What do you think, honey? I don't know.
I mean, is surgery really such a good idea? He just seems so sick.
I just You should do whatever you think is best.
Is this the only way to go after this thing? Because of the rapid progression, I don't think we have time to test or try IVs.
And he's strong enough to endure anesthesia? Definitely.
I want you there during the surgery.
Of course.
You gotta do it.
Good.
Dr.
Chase will be in here soon to get you set up for the OR.
Page Dr.
Chase to Tucker's room for a surgery consult, and can you get me Mr.
Koplovitz wants to talk to you.
Is everything all right? He wanted to talk to his doctor, not his doctor's assistant.
Oh.
And House is looking for you.
What'd you tell him? That you were in the clinic.
I figure that gives you about 10 minutes.
Here, Mr.
Koplovitz's chart, go.
Hello, Saul.
I heard you were looking for me.
I'm very tired, but I can't sleep.
Today's your lucky day.
I happen to be a sleep specialist.
Thanks, Doc.
Hey, can't a guy get a little privacy? Nice hiding spot.
Actually, it's perfect.
It allows me to hide from Cuddy and find you.
What did she want? She was checking up on Tucker, thanks to you.
That's it? Like what? Something about you? Something you could interpret as being about you? An anagram maybe? It'd be great if you could play hide and seek somewhere else, my patient's No problem.
Just give me the 100 bucks you owe me and I'm gone.
Tucker doesn't have cancer.
He doesn't have a ball of fungus in his lungs either.
Next time you want to use my team, I suggest you at least leave a tip.
I'm late for surgery.
Ah.
Your assistant said you'd be in here.
I talked to Bonnie.
Let's take this outside.
Mr.
Koplovitz just got to sleep.
Oh, sorry.
She found us this fantastic loft.
Outside.
It's not a loft, it's just more urban.
Not that I'm urban, but I used to be.
It's got two bedrooms, got wonderful views.
It's a really great place.
Procedure should take about an hour.
I'll be observing the entire time.
Thanks.
Maybe it'd be better if you would stay with Ashley.
She's more scared than I am.
Well, she's At her age, she's not supposed to be dealing with issues of life and death.
Wasn't what I was planning when I went after her.
Why did you leave Melissa? We got married young.
We I'm not sure.
There's nothing to talk about.
Why are you doing surgery when I need you finding me a new case? You don't want a new case.
Oh, right.
Guess I'm here for Wilson.
Obviously, you didn't tell me that Cuddy was moving in with Lucas because you were protecting me, which is odd, since I told you that I'm fine with their relationship.
So, obviously, you question one of those assumptions or you have an issue with logic.
Yes, you're fine with them dating.
But moving in together is a whole other level of commitment.
This is the 21st century, Wilson.
I realize that the logical course in any adult relationship could one day lead to fornication.
Although, the fact that she wants to buy a loft could actually mean that their relationship is not as serious as I thought.
Oh, for God's sake, House, don't do this to yourself.
It's a loft, it has no deeper meaning than open-spaced living arrangement.
You bought into her diatribe about rediscovering her lost city-girl roots? And two bedrooms, it just reeks of commitment issues.
Yeah, or she has a baby.
Well This is classic mid-life Cuddy crisis.
This is her version of a two-seat convertible.
Yep, clearly you're fine with it.
Wilson, he's got global lung damage.
Means it's not fungal.
It's PCP pneumonia.
Hmm.
Obviously, something is knocking out his immune system.
Three options: HIV, acquired SCID, or, my personal favorite, cancer.
I'm sure you'll test for all three.
Sixty-two-year-old African-American man with lymphoma now in remission.
I did a CT and found a small lesion on the upper lobe of his left lung.
But if he's in remission, why did you bother scanning him? During a routine follow-up, I realized the patient was depressed.
Wow.
That's quite a call.
Thanks.
The treatment indicated Oh, I'm sorry, I didn't realize you were in the middle of something.
It's a conference room with glass walls.
You thought I'd be alone? Your patient has cancer.
Not that guy, who probably also has cancer.
And who's probably also your buddy.
Thought you'd want to know.
And you owe me You have acute lymphoblastic leukemia.
ALL.
So it is a recurrence? No, it's different.
It's a second leukemia, probably caused by the chemotherapy we gave him five years ago.
That's why you didn't see it? Maybe they can rename it Ironic leukemia.
This is not the end.
Tests show that the cancer is limited to your brain.
That's good news.
How can cancer in his head be good news? The blood-brain barrier separates the blood in your head from the blood in your body, keeps the cancer bottled up.
We can go for a cure.
So give me the numbers.
What are we looking at? Ninety percent chance of cure.
Really? What if we're in the 10%? Steady decline, but six months of a good quality life.
Does he have to go through another bone marrow transplant? No.
Chemotherapy.
We can go at this with drugs alone.
When do we get started? We begin by surgically planting a shunt, so we can get the drugs directly into your brain.
I already booked the OR.
You're the only one who can make cancer sound like good news.
We get it out of your head and you walk out of here.
Paralysis gone and cancer free.
We also need you to sign a healthcare proxy.
If something goes wrong in surgery, someone needs to be appointed to make decisions for you.
What are the chances of that happening? Very remote.
I think maybe Melissa should be my proxy.
What? No.
Coming through.
House got a new case.
Revised OR schedule.
Sorry, Wilson, had to bump you.
It's not like your guy is bleeding out of his eyes.
House, your guy's not bleeding out of his eyes, either.
The nurse who books the OR thinks he is.
Your case is no more urgent than mine.
Yeah, but you're way more patient.
It's okay.
You can talk about the paperwork in the prep area.
You trust her more than me? About this, yes.
You've been through the good stuff, but Melissa's been to hell and back with me.
She gives me the best shot of getting through this.
You still love her.
Don't be silly.
I love you.
Please, don't make this into more than it is.
Okay.
Anything? No.
Can you feel this? No.
How about here? No.
Where is everybody? Melissa and Emily went downstairs to get some breakfast.
Ashley? She had work to do.
I thought she was off today.
Well, she didn't really have work to do.
She's just pissed, so she pretended to have work to do.
I let her pretend.
Okay.
Move your fingers.
The chemo's not working.
Does that mean it's not cancer? No.
It means the chemo from your first round of treatment has made the leukemia resistant.
So I'm in the 10% that don't get cured.
Maybe not.
We just removed a screw from a guy's lung, and the weird thing is, he didn't get better.
Any idea what that means? It means you're not listening to me.
No, it means I'm ignoring you to make a point.
There is a difference.
The problem with that technique is I have no idea what point you're making.
That your idea is implicitly not worth responding to.
Doubling your patient's chemo dose is stupid.
Damn, now it's explicit.
It could swamp out the resistance of the cancer cells.
The fact that it theoretically should work doesn't make it any less stupid.
Of course it does.
It's exactly what you would do.
I'm me.
You're you.
And a table is a table.
And chemo is poison, and double chemo is double poison.
And I can handle it when things go wrong.
You can't.
And things could go very, very wrong.
I can handle it.
Sounds pretty dangerous.
It is.
What do you think, Mel? I think you should call Ashley.
You're my family.
I'm sorry I forgot that.
I think that you should try whatever could keep you with us longer.
Yeah.
Look.
I can move them.
Hey.
Thank you.
What is it, Jim? I'm gonna need to run some tests.
Intraepidermal superficial bullae.
Could be pemphigus.
Or it could be from the fire.
Either way, he's dead.
We can't stop the oozing.
Don't care.
I'm here because it's 1:15 and Wilson started testing at 12:45, which means The cancer is gone, but over half his hepatocytes are dead.
In only 24 hours? He needs a new liver.
Look on the bright side.
You can publish the results of this case study.
No one will ever double the dose again.
The double dose of chemo got rid of your cancer, but it also trashed your liver.
If I don't find you a new liver You've only got about 24 hours left.
So what do we do now? Your father's been moved to the top of the transplant list.
But all we really can do is wait.
That's it? We wait? Tell me something that I can do.
I'm sorry, Mel.
You and Emily don't match Tuck's blood type, and neither does Ashley.
So a live liver donation is out.
The best thing to do is just what you've been doing, be together.
Hope he already told you that you're gonna die, 'cause it's gonna make what I'm about to say a lot more relevant.
House, I know it's raining out there in the hallway, but I was just in the ER, testing my patient for autonomic dysfunction.
It's the only department with a shower big enough for the whole team, plus the cardiac monitors, plus me, plus Anyway, relevant part.
We're just wheeling the guy out, a trauma came in.
Motorcycle versus semi.
How bad? Bad for the motorcycle, good for your liver.
Blood type's a match.
Why wasn't I paged? Because there is a problem.
No organ donor card.
Dead guy's sister is next of kin, she's refusing to allow the donation.
Where is she? Twenty minutes away.
How do you get the call that your brother's dead, and then run out the door? "That reminds me, "I had dry cleaning to pick up.
" Did Cuddy buy the place? Not yet.
You okay? Just making conversation.
Yours was getting boring.
What are you planning? I'm not planning anything.
And I don't believe you.
How are you gonna punish her for dating Lucas? Okay, now this conversation is getting boring.
Are you really okay? No.
I am not okay.
Not even close.
Wow.
Okay.
See, that's very adult of you.
No, it isn't.
It's just me accepting the fact that there's nothing I can do and moving on.
Which is, I think, the definition of adulthood.
Well, if it is, being a kid is a lot more fun.
It's show time.
I didn't speak to him for years.
But when my parents died, at their funeral, we made peace.
Our parents must have blessed it.
And I'm sure they would want him to do good with his last act in this world.
They wanted us to be friends.
Our relationship wasn't strong, but it was growing.
If I allow you to defile his body, it will destroy that bond.
The itai will be harmed.
It will save my patient's life.
What if I told you that he wasn't dead? Are you saying my brother's still alive? I'm saying you're being an idiot, but I don't have time to talk you out of your religion, so I'm stuck with giving you a technicality that will let you justify doing the right thing.
What if his last living act was to donate a part of his liver? Not the whole thing, just one small piece.
Then I'm not defiling a dead body.
House.
The last generous act of a living person.
House.
It's too late.
The liver started to degrade.
It's no longer viable for transplant.
Well played.
Religion just killed another person.
It's not fair, Jim.
You just helped me get my family back together.
I'm not ready.
I would've had six more months with them if you hadn't given me that extra chemo.
Now I have less than one day.
I'm sorry.
We knew the risks.
I don't want to lose them again.
I can't lose them again.
There's nothing more we can do.
Five years ago, when I needed a transfusion, you used your own blood.
We have the same type, which means you can give me a part of your liver.
I'm your doctor.
You're my friend.
Should I die because you're also my doctor? Of course not.
Fine then, you're fired.
Now you're just my friend.
Now you can do what's right.
Tucker, it's I can't.
Late night with the Pigeon sisters? Every now and again, I'd like to come home without getting interrogated.
Someone's cranky.
And late.
Where were you? Was getting a drink.
Why are all my frozen dinners thawing on the counter? I needed room for my margarita jello shots.
I used test tubes as bottles so they'll be shaped like my cane.
Why did you go out drinking alone when you got such great company here? Tucker wants me to donate a lobe of my liver to him.
You were out drinking because you're actually considering this? Yeah, I was out marinating my liver in alcohol to get it ready for the transplant.
Yeah.
Your mouth says no, but your pathetic attempt at a deflection has guilt written all over it.
It's my fault.
It is my fault.
I gave him too much chemo.
You cured his cancer.
And killed him in the process.
Quibbles.
He's had a predictable complication.
Surprise.
Bad things happen to people who are sick.
Doesn't make you responsible.
Oh.
Not legally, ethically.
Ethically.
A table is a table.
Don't be a doormat, Wilson.
Boy, you are You willfully ruined my food and have taken over my living room because you already think I am a doormat.
You know what? You're wrong.
Clean up your stuff and get out.
You're wrong.
How's Tucker? Still no dancing.
But the scans came in on Del Clinton.
It's good news.
Thanks.
Let me know as soon as Tucker takes a turn for the worse.
I want to be there.
See that small spot at the top of the lung? That was then.
This is now.
The spot's gone.
That tiny little spot, huh? Yeah, it's not too impressive, is it? That little dot could have killed me? Yeah.
Fortunately, we caught it early.
It's gonna be okay.
That's amazing.
You got all this off me not talking about my grandkids.
Thanks, Bonnie.
We're just gonna have to sit tight for a while.
Okay.
I put an offer on the loft.
Seller turned me down.
I offered exactly what a similar unit sold for three months ago.
I want to donate a lobe of my liver to Tucker.
That's insane.
I'm donating a small portion of You have hundreds of patients.
And until I run out of excess organs, why shouldn't I do everything I can to help them? Because you're a doctor, not a donor.
Why did you make me the head of oncology? Not because you have the most organs.
You're thoughtful, caring.
Yeah.
Caring.
By your own criteria, a strength and not a weakness.
This is coming out of guilt.
This is coming out of friendship.
I have a friend who's about to die.
And I have the opportunity to save his life.
Okay.
Call me a doormat, get it all out of your system, but I'm doing it.
Why? He's my friend.
I'm your friend.
All the pain pills I've taken? What if I need your liver? Right.
How selfish of me not to have considered your possible future needs.
They're all dying.
They're all your friends.
I'm not here for an argument, House.
No, right, that's room 12A.
So why are you here? You wanna make sure that I've called a moving van? No.
The operation is in two hours, and I'd like you to be there with me.
No.
Why? Because if you die, I'm alone.
Thanks, Jim.
How are you feeling? Can't complain, considering if it weren't for you, I'd be dead.
Twice.
You? I feel good.
Sending out your laundry? Going to rehab.
Someplace up in Katonah.
Up by your new house, not near your old house.
Easier on Ashley.
I see.
I was thrilled to get the family back together, and Melissa's great in a crisis, but the person you want when you're dying isn't the same as the person you want when you're living.
Hi, Jim.
Actually, it's James.
You ready to admit that he's a self-important jerk? I still feel good about what I did.
You don't feel angry? Oh, I'm a little disappointed.
Disappointment is anger for wimps.
You don't have to be so gentle about everything.
It's okay to get angry once in a while.
You can't change a table.
Actually, you can.
You just need a coat of paint and the guts to use it.
Bonnie.
Bonnie told me what Cuddy bid.
You're gonna outbid her? We do need a bigger refrigerator.
She hurt my friend.
She should be punished.
You got mad.
I'm proud of you.
Cuddy won't share that sentiment.
How are you going to explain it to her? I'm changing our address to a PO box.
She'll find out eventually.
A problem delayed is a problem denied.
Bonnie? I'll take it.
Baby steps.