House, M.D. s06e15 Episode Script

It's estimated the observable universe is 93 billion light years across.
It's probably more accurate to I'm gonna be so far away.
I don't care.
I don't wanna break up.
I'll come on the weekends.
Stanford's on the other side of the country.
My dad has like 10 million frequent flier miles.
He won't care.
We all right over there? Yes, Mr.
Damon, I just had something caught in my throat.
Abby, you know you're not supposed to have any food or drinks in here.
It's just water.
I have a cough, I didn't want to disturb anyone.
We can only observe The rest of it is unaccounted for.
I never knew you were such a good liar.
Well, a little more vodka and you might find out some more things you didn't know about me.
Really? Nicholas.
Yes, sir.
What conclusions can we draw from the incredible number of stars? That the movie's either gonna be really good or really bad.
I was thinking more about the implications for extraterrestrial life.
Well, I guess if there's an infinite number of stars, odds are there's at least one galaxy with life other than our own.
Or? Or not? Or our solar system is somehow unique.
The question then becomes, in what way? The question then becomes, could you possibly teach us anything more useless? What're you looking at? Abby? Oh, my God.
Something's wrong! She's not breathing! Call 911! Would you mind at least putting a napkin under your jelly toast? Get a table and I won't eat on the couch.
Yes, you will.
But I won't have a good excuse.
Why don't you go get a table? It's not my condo.
You have my permission.
Pick out whatever you want.
Then it would be a reflection of me, not you.
That wouldn't be right.
No, it would be a reflection of the fact that the guy who's been mooching off of me for as long as I can remember isn't a complete ingrate.
You've never furnished a home.
I have furnished a bunch of homes.
No, you've married a bunch of women who've furnished a bunch of homes.
You want to eat off something, fine, move your piano in here and eat off that.
You're afraid.
Of a dining table? You know, they don't actually come to life when you put a knob off your bedpost on them.
You are what you sit in.
Your friends, your job, your furnishings, it all defines you.
You don't really believe that.
You just don't want to do the shopping.
Buy some furniture or admit that you're empty inside.
Hmm.
X-rays confirm the fluid that almost suffocated her to death was from pulmonary edema.
Means the problem is either in her heart or lungs.
Tox screen's clean for everything except the alcohol, and her BAC was barely .
05.
Means she only had one or two drinks, tops.
And there's no sign of trauma.
How did you know? Because if there was, Cuddy wouldn't have needed me to take the case.
How'd you know Cuddy Foreman's the only one with the balls to take a case without checking with me and he's still working on breakfast, which means that the 18, no, 17-year-old honor student Cuddy has a soft spot for smart girls, and they don't start drinking until second semester senior year.
So, either you think that smart women look out for each other, which means you're an idiot, or you think Cuddy's not smart, which means Well, I guess it's the same both ways.
Then how did you Picture fell out of the file.
She looks smart.
Where's Taub? You don't already know? Yeah, he's at home in a fight with his wife.
I'm just curious what he wanted me to know.
His car has a flat tire.
He's waiting for a tow truck.
What about rising blood pressure from binge drinking? It could set off a hypertensive crisis, cause heart failure.
Two drinks is hardly a binge.
Certainly not if you're an Aussie, but when an American school girl has two drinks before 10:00 a.
m.
, it's a pretty sure bet that the plan is to have a lot more.
It probably wasn't the first time she had that plan.
We'll get a C-13 pyruvate MRI to check for cardiac lactic-acid levels.
Someone call Taub.
Tell him to cut the ball and chain on his own time.
We're arguing about couples yoga.
No.
We're arguing over the fact that we don't ever do anything together anymore.
We don't ever do anything together? Chris, I love you, but I swear, if you start talking to me like I'm on the witness stand again, I'm gonna break your neck.
Honey, we do stuff together all the time.
Really? Like what? And besides sleeping, watching TV, going out to dinner, what do we do together, just the two of us? We You don't like going out to dinner? All right, I'll do the yoga.
Forget it.
Now you don't want me to do it? Just go to work.
No.
I'm not leaving until we work this out.
I'm fine.
Please, just go.
Where's Abby Nash? I'm Nick, her boyfriend.
This is my dad.
Hi.
You can wait in Where is she? Is she okay? She's having some tests run.
Is she okay? We think her drinking may have damaged her heart.
Her heart? No.
She doesn't drink.
Not that much.
Just when she's at school? Nick, what's he talking about? It was a field trip.
One of the kids had a fake ID.
But, Dad, you know Abby.
Tell him.
I know what she's like when the two of you are around me, but If you're right, the tests will come back negative.
Can you give her a message? I brought her homework.
And I love her.
Sorry I'm late.
Nick loves you.
House doesn't believe you got a flat tire.
What does he think I was doing? Fighting with the wife.
Why would I lie about that? She wants me to do yoga.
We need thinner cuts.
When you and Cameron had disagreements I'm probably not the best guy to go to for marital advice.
Sorry.
It's just What's that in the mitral valve? All right, I get the message.
No.
No, I'm serious.
What is that? Could be a fungus.
ER drew blood cultures.
All negative.
No parasites, no fungus.
Could be fastidious enteric bacteria.
You think she's been eating your wife's cooking? Hey, I'm on your side, man.
I am not fighting with my wife.
I had a flat tire.
It's in my trunk.
You can go look at it if you want.
Don't need to.
Face tells me you're bluffing.
Not yours, Chase's.
If she was infected through the intestinal tract, she'd have intestinal symptoms.
There are other ways to get enteric bacteria into the bloodstream.
She's not an intravenous drug user, she has no tattoos, and she doesn't have any scars that would indicate she's a cutter.
Transesophageal echo could give us a better idea of what we're looking at.
If that valve is about to dehisce, echo could trigger a heart attack.
So come up with a better idea, or have a crash cart ready.
Why are you lying to House? Chase told me.
What's the big deal? Maybe we can talk about this another time.
Or never.
I really don't think she's gonna tell anyone.
If I admit we were fighting, he's gonna want to know what about.
So tell him, or tell him it's none of his business.
This is easier.
Really? Because it seems much harder.
What do I know? I'm not a guy.
Yes, if only I could be as open about my emotional life as you are.
It's not about the yoga.
Really? I thought it was, since we spent an hour talking about yoga, but what do I know? I'm not a girl.
My guess is she thinks you don't want to spend time with her because you're spending it with someone else.
If she thinks I'm cheating, she would ask.
Because you'd tell the truth? I'm not seeing anyone else.
Doesn't matter.
You have a history.
And that's not her fault.
So what am I supposed to do? I can't prove a negative.
That is a problem.
There's the heart.
Valves look fine.
No vegetations.
No myxomatous changes.
Can you give her a little more sedative? She's dissecting.
She's rupturing.
Get the scope out.
This doesn't make sense.
Her BP's normal, and her heart rate was controlled.
We'll figure it out later.
We've only got about 30 seconds to get her open.
No leakage from the cannulation site.
Nice.
Let's see if she'll start up.
Cardiac paddles.
Charging.
And go.
Come on.
Again.
Go.
Pushing five cc's adrenaline.
Zap her again.
No.
It's not working.
Clear.
Clear.
Normal sinus rhythm.
Thank God.
TEE and intra-operative visualization showed no vegetations on the valves, no structural abnormalities.
The dissection means we were wrong about alcohol causing a hypertensive crisis.
And by "we" you mean "you.
" Yeah.
You were the one who didn't have any better ideas.
It's not my fault.
I was busy trying to judge Taub.
Since we already ruled out trauma, the dissection's probably a genetic defect.
We're running the tests.
She's not marfanoid.
What about an allergy? A severe enough one could set off a systemic immune reaction, cause fluid in the lungs and inflammation that could weaken the aorta.
If it was an allergy, she'd be getting better in the hospital, not worse.
Unless it was inside her.
Meaning? You want my sperm? We think a severe allergic reaction could be causing a systemic breakdown.
To my son's sperm? Actually, his semen is more likely the problem, which I realize is not what you were reacting to.
When's the last time the two of you had unprotected sex? Never.
I use a condom.
You always use a condom? For everything? Well, for most everything.
When? The night before she collapsed.
I'm placing a drop of Nick's semen protein onto the skin.
Then I'll abrade it with a needle, check for a rash in an hour or so.
Mom, come on, we've been dating for three years.
I'm not mad, sweetheart.
I'm just confused.
A systemic reaction can be triggered by the protein in semen.
In most cases, the reaction is fairly minor, but in rare cases, repeat exposure can trigger a hypersensitivity response.
"Repeat exposure"? I know, I know, three years.
Is this supposed to hurt? A reaction should take longer than No, it's not that.
Ow.
Abby, what's wrong? My stomach.
Blood in the urine.
Help me! No allergic reaction.
On the other hand, now her kidneys are failing.
Could be some kind of neuropathy.
Syphilitic lightning pains? It's not syphilis.
VDRL and enzyme immunoassays were negative.
What about a blood clot? While she's on anticoagulants for the aortic surgery? Interstitial nephritis? Wouldn't cause the edema or dissection.
But cancer could.
Would you care to be a little bit more specific? If I could, I would've.
We could do a full body scan.
We hate full body scans.
And by "we" you mean "you.
" We also hate when a patient dies before we figure out what's wrong with them.
Do the scan.
How can you convince someone you're not cheating on them? Don't cheat.
After a while, they'll catch on.
What if I don't want to wait that long? Take them with you wherever you go for 24 hours a day.
So your wife's a little insecure.
Is that so bad? At least you know she still cares.
I know she cares.
What I want is for her to be happy.
What? You don't think I want my wife to be happy? Sure.
As long as it makes you happy.
What do you think? I think you work quickly.
Piece of cake.
You give them money, they give you furniture.
Not bad, huh? Nope, it's not bad at all.
It's taking a really long time.
Just hang in there, and try not to talk unless you really have to.
It can affect the images.
What was that? Hello, are you still there? I think there's something wrong with the machine.
It's not the machine.
It's an earthquake.
Hold on, we'll get you out.
Get me out now.
Oh, my God! I can't hold on! It's a black hole.
She's hallucinating.
I certainly hope so.
Hallucination means brain problem.
Brain problems don't split your aorta.
A vascular problem could explain both.
Inflammation in the blood vessel walls leads to dissection in the aorta and could cause an aneurysm in the brain that could cause the visions.
It's a bit convoluted, but brain and heart function are susceptible, too.
If there was any sign of the inflammation of the aorta, that would make sense.
House! That's not funny.
I've got enough problems already! Trust me, this is gonna help.
An aneurysm explains the hallucinations, and it's the one thing we haven't excluded from the differential.
Your texting does not prove you're faithful.
It just proves you know she thinks you're unfaithful.
You can't force trust.
What did she hallucinate? The content of the hallucination isn't relevant.
Not usually.
Not ever.
We know nothing, brain knows all.
You get an ulcer, you don't know it, but the brain increases mucin secretions.
It knows what the problem is, it knows where the problem is.
It's a big logical jump from a body's immune response to the brain giving subconscious diagnostic clues.
What about dreaming about waterfalls, running streams if you need to go to the bathroom? Sure.
That's the same as the brain shouting, "You have pancreatic cancer.
" Her subconscious is trying to tell her something.
We need to eavesdrop.
She was screaming she was being sucked into a black hole.
So we should look for a tumor in her anus.
We need the whole story.
A cognitive pattern recognition program might tell us what's going on in her head.
Or we could act on something based in science, not science fiction.
Get an MRA with contrast to see if she has an aneurysm.
Unless you think Cuddy's gonna go for the mind reading.
Fine.
Do the MRA.
When it comes back negative, we can move on to the crazy, but possible, ideas.
What did you do with the furniture? I returned it.
You told me to buy it.
But you didn't buy it.
You rented it.
You made one phone call to Economy Furniture Supply.
"We get it done, so you don't have to.
" So what? We had a table, chairs But no clue what any of it meant.
Fine.
I'll hire a decorator.
Perfect.
Another woman to tell you who you are.
I'll hire a male decorator.
Step inside one furniture store and find one thing you like.
I like not doing this.
One.
Abby.
Hi.
Where's my mom? She went down to get some breakfast.
How are you feeling? Well, besides the fact that I can barely breathe and I ache all over, not good.
Anything I can do? Just don't go.
I'm not going anywhere.
Been a while since we've gone more than a day without doing that.
I'm not going anywhere.
What'd you say? I've been thinking Been a long time since we went more than a day without doing that.
We have a secret.
Now, you don't need to answer right now, but, Abby, I want to marry you.
Tell him the secret.
It's okay.
Something's wrong.
What? Abby, what are you feeling? I don't know.
Your secret is killing you.
I see Maybe it's all the medication.
I was just Abby, can you hear me? You deserve to die.
I need four milligrams lorazepam.
She seized for over a minute.
Inner-ictal EEG showed no synchronous discharges.
And the MRA? No aneurysms or arterial or venous malformations in the brain.
As predicted.
What did we say we'd move on to? Out of body experiences can be induced by sensory overload in the temporoparietal junction.
Temporoparietal junction was clean on MRI, MRA, and whole body scan.
Which just leaves us with the question of what happened during the out of body experience? If I say her blood pressure shot up over would that be a satisfactory answer? Sure.
If you then went on to answer the following, did she float above her body? Did she see Jesus? Did she bathe in the Ganges? No, no and no.
Can we get back to the medical science? No.
She claims she emerged from her body as a younger version of herself and started talking.
She couldn't remember what was discussed.
But I'm sure it wasn't a differential.
House, cognitive pattern recognition is 50 years from being a useful diagnostic tool.
Even if we can get the equipment, it takes hours for the initial mapping.
If she has another seizure, she could stroke out.
Coincidentally, she could also have a stroke if we do nothing.
I'm not telling a mother who's scared out of her mind that our best shot is a magic trick.
It's not magical, it's experimental.
Just like washing your hands after pooping once was.
And technically, it's not our best shot.
I'm pretty sure it's our only shot.
Perfect.
So, Foreman, go get her consent.
The rest of you, go down to the cog-sci lab.
The equipment should already be there.
I'll catch up.
Thanks for the invite.
I am not sure I'm up for the hospital food.
Good, 'cause I wasn't planning on lunch.
While you watch video clips, a computer maps how your brain processes the images.
How long will it take? Six hours.
But that's really just the prep.
Once the computer maps how she processes the information, we'll put her under twilight sedation, use the same equipment to monitor her unconscious thoughts.
Hopefully, it'll spit out a very basic video of whatever's going on in her head.
And what will that tell you? Hopefully, it'll give us a clue as to where your brain thinks the problem is.
A lot of "hopefullys.
" Could it hurt her? We're at a diagnostic dead end.
We've got to try something.
This is much better than lunch.
I agree.
What made you think of this? I missed you.
No, I mean this.
The car in the parking lot.
I just don't like feeling like maybe this isn't the first time you've done this.
It's the first.
I love you.
You know that, right? Yes.
I want you to be able to trust me.
And I want to, but Inspiration Point doesn't open till after dark.
Got a real cool magic show about to start.
Also, I'm gonna need to check your spare.
Abby, can you think of something specific? Like what? Doesn't matter.
Just make it a single image.
What are you thinking? About Nick playing baseball.
Holy crap.
That's amazing.
Yeah.
Now all we have to do is read her subconscious and hope that it's completely rational and went to med school.
Does anything get you excited? Can I help you with something? Yes.
I was wondering if you could tell me a little bit about this dining table.
It's made of wood and you eat off it.
So you're paid by commission? It's furniture.
Find something you like, let me know, I'll ring it up.
Thank you so much.
Okay, that's That's not That is a remarkable collection, if I can show it to you.
I'm Gabriella.
I'm really just looking for a nice dining room table.
I see.
You're daring.
Yes, I do that sometimes.
But right now, why am I daring? You're not constrained by rules.
What else attracts you in the patio section? Wait.
This is a patio table? For outside? Well, it's taken us just over an hour to prove that she has a very boring subconscious.
Anyone ever tell you you can be a real buzzkill? Yes.
Stars.
Maybe that's a stripe.
It's the sky.
She's thinking about the moon and the stars in the sky.
She's going to Stanford to study physics.
It's not a big revelation that she'd think about the sky.
Or a star could be a white blood cell.
Leukemia? Who's that? Her dad? He died when she was eight.
What did Daddy die of? Private plane crash.
No connection.
Stars, moon, sky, white blood cells, heart valves, black holes, or anus, or a million other circular passageways into the body, and her dad.
What do you think it means? She likes school and she has daddy issues.
Neither of which helps us.
So now what do we do? Start over? We obviously missed something.
What about the liver? What about her left toe? Oh, sorry, I thought we were randomly picking out body parts that had nothing to do with her symptoms.
Liver's responsible for proteins, immunological effects, production of red blood cells.
Might be able to explains the lungs, the hallucinations Not the aortic dissection.
Her kidneys are also failing.
Polycystic disease could explain the dissection.
So, that's one imperfect theory plus a rare complication of a second theory, which gives us a complete explanation.
Don't polish the notion, Foreman.
Pineal gland is calcified.
It's supposed to be calcified.
Happens after puberty.
What if it's obscuring a tumor? It's the only place we couldn't look inside.
Get a better look at her pineal gland with three Tesla fast-spin echo MRI.
You're pacing my office 'cause you're buying furniture? No.
I'm pacing your office because I'm physically incapable of buying furniture.
For Amber's old place? Yeah.
It needs some new I know you bought the place I wanted.
You're a jerk, let's move on.
Hire a decorator.
I'm supposed to find me.
Backpack through Europe.
I know it's hard to believe, but you know what says even more about who you are than your furniture? The fact that you are letting House tell you how to buy furniture.
Call Beatrice.
MRI revealed no remarkable features on her pineal gland, but there were slightly elevated levels of lactate dehydrogenase isoenzymes.
Which we would expect to see if there was an allergic reaction happening.
There's definitely no allergy.
Parasite? There's this Middle Eastern parasite How exactly do you want to be shot down? On the basis of the fact that she's never been within 6,000 miles of the Middle East.
Or on the basis of the fact that all our scans and urine samples came back clean.
And yet she's still failing.
System after system.
So, either we find the answer at autopsy or What? I got nothing.
I was gonna head out.
If there's any change, I assume you'll page me.
Are you having an affair? Does it bother you that your wife doesn't have the guts to actually ask that question and I do? On both ends, yes.
Difference is, I'm not afraid of the answer.
And I might believe you.
I'm not having an affair.
But you want to.
No, I don't.
I'm through living like that.
Why? What, you finally got to the point where half your age plus seven just isn't young enough? Talk to you later, House.
Or is it because you now really are old enough to be their The dad.
Does he travel for work? What do you mean, does he? He died almost 10 years ago.
Not hers.
Her boyfriend's.
He's the one in her visions.
I'm your son's girlfriend's doctor.
Oh! It's a mouthful, but probably not as tricky as your title.
Okay.
Is Abby gonna be all right? Do you travel a lot? Yeah, I have a food import business.
Why? Where do you go? All over.
France, Italy, the Mediterranean? Why? I think you exposed her to a parasite.
Oh! I thought the scans didn't show any.
Because she doesn't have any.
But you just said It's cool.
My theory is that her body was able to kill off the parasite, but what it couldn't do was get rid of the shell, which doesn't show up on the scans.
That little piece of microscopic garbage set off an allergic reaction called Cerebellar Schistosomiasis delayed Hypersensitivity Allergy or "CSDHA.
" Risky, unpleasant treatment, but completely curable.
Well, that's fantastic.
You'd think so, wouldn't you? Only thing is, did you ever have sex with your son's girlfriend? Where the hell do you get off Shut up.
See, I can't treat this unless I can confirm it.
The only way she could have been exposed to this parasite is sexually, which means she's gonna die very soon unless you admit that you slept with her.
Dad.
What's going on? Gee, this is bad, because you now have to choose between her living and the truth becoming public, and frankly, given what the truth is, it's a tough call.
You'd broken up.
She was crying Your girlfriend is not allergic to your semen.
She's allergic to the Egyptian parasites swimming around in your dad's semen.
You slept with Abby? I was drunk.
We both No need to explain.
Technically, she was legal.
Wait, wait! Wait! Hey, all things considered, it's actually great news.
So, what do you think? You wussed out and used a decorator.
Why can't that be me? A wuss who loves decorators.
Because it's not.
Okay, it's not.
But don't return it.
I can't keep doing this.
You have to.
You can't keep letting other people define you.
Not another elephant.
The decorator didn't pick this.
You're gonna have to buy your own cape.
I like what this says about you, Wilson.
Wait, I don't remember him at the wedding, do you? I don't remember most of the people who were at our wedding.
Which is why I thought I'd ask the love of my life to marry me.
We're already married.
I want to be better at it.
Well, that's beautiful.
What did you tell him? That it doesn't mean she doesn't love him.
And he bought it? It's true.
Your wife say yes? How did you know Monkey see, monkey do.
At least he has the "young and stupid" excuse.
She said yes.
Good for you.
Thank you.