House, M.D. s07e11 Episode Script

If you're going to dress like an Italian hooker, at least let it be this year's Italian hooker.
She's not telling us we look fat.
It's a major breakthrough.
If you didn't want to be insulted, you wouldn't have invited me.
Would anyone like some champagne? No.
Yes.
Three glasses, please.
- Mom.
- It's not even lunch.
If you'd prefer, I'll make it a mimosa.
What do you think? Perfect for a night on the town.
Perfect for breastfeeding.
My heart's doing that weird thing again.
Beating? That's normal for humans.
Come on, Lisa.
Take her seriously for once.
What? What is it? I think we need to get you to the hospital.
Is no one gonna tell me Why we're in the morgue? House is on the lam from someone.
Taub's got his money on Wilson, but I'm pretty sure it's Cuddy.
Fool's bet.
There's a whole world of angry patients, creditors She needs a doctor.
Yes, just not me.
Your mom is a 65-year-old woman with high blood pressure.
What about the macrocytic anemia? Borderline, which is the lab equivalent of imaginary, which, by the way, matches the rest of her medical history.
You really think she's psyching herself into atrial fibrillation? So get her a cardiologist.
You don't want me involved.
You don't want you involved.
You know all that ethics stuff that I don't give a crap about? It suddenly makes sense.
If you're emotionally invested, you cannot make rational decisions.
You know this would be a disaster.
This is my mother.
Treadmill test went well.
No chest discomfort or ischemia.
The abnormal rhythm will probably resolve itself, and if not, a daily pill will keep it under control.
I will follow up later today.
Is it connected to my other symptoms? Which other symptoms, Mom? Not her fault.
This Dean of Medicine stuff, very impressive at parties, but she's forgotten how to be a real doctor.
It's all in my file.
There are 15 years of clinic visits in this file.
I don't want to be a bother, but isn't this what you do for a living? So, we're looking for a disease that can last a decade and a half, causes constipation, diarrhea, flu, colds, dizziness, rashes, back and joint pain, heart feeling "weird", kishkes feeling "wobbly".
One actual hip replacement.
And which has eluded detection by years of blood work, X-rays and MRls.
Well, one thing does pop to mind.
We'll monitor you.
And we'll give you a thyroid test.
And House's team will do a home search for environmental toxins.
He seems to know his stuff.
How come he can't afford a coat that fits? No radon, no mold, no lead in the pipes.
Yeah, yeah, great.
Have you seen Cuddy's high school yearbook? Okay, that is clearly not related to the case, so There is no case.
Cuddy won't let House see the yearbook, so he figures there's something to hide.
Any guesses? It's clearly related to being a giant teenage dork.
So you thought I'd have some insights? Oh, no, no, I didn't mean that.
Relax.
I was crowned Homecoming Geek.
I'm sure you can relate.
Because you knew some dorks? I was the class president and head boy at Ah! Is that Cuddy's mom? Certain parts of her.
And certain parts of some muscular Hispanic gentleman.
Should we consider STDs? I think I just caught one looking at these photos.
What does "azarcon" mean? It means we might have an actual case.
Mexican herbal medication for stomach problems, but only in the sense that lead chromate is an herb and poison is a medication.
I'll start a chelation IV.
Thank you so much.
Wasn't too much of a disaster, was it? You know, it's not the only thing they found in her home.
Not my yearbook.
Nope.
Just some stuff that could cause severe nausea and permanent erectile dysfunction.
And which proves that your mom is doing the help.
According to her diary, it's some contractor named Jesus.
Which, granted, was originally a Jewish name, but Go, Mom.
So, why were you taking a Mexican folk remedy? A friend uses it.
A friend.
Mom, just for medical reasons, you should have told me.
If you're sexually active At my age, he's more the active one.
Mom's having a fling.
I know.
You do? She's been giving me lousy advice about it for five years.
I have physical needs.
He's a married man, Mom.
She doesn't want sex with him, I do want to have sex with him.
Tell me who's being hurt.
Hold on.
Five years? Why didn't you tell me about it? I don't know.
We don't have that kind of relationship.
Does that really surprise you? You're not ready? You said you had two guys helping you move.
They couldn't get out of work.
I'm trying to economize.
And this hotel is cheaper.
Hi.
I'm sorry.
I just wanted to drop off some mail and talk to you about something.
Of course.
Rache.
Chris, that's not why We got to move on.
And what does that mean? Have you moved on? With who? Is it Phil? I don't want to talk about this.
I know that you're worried about money, so You're trying to change the subject.
Yeah.
Which you could have gleaned from, "I don't want to talk about this.
" I got you a tryout to be a part-time medical consultant on law suits.
Wait.
With your brother? Have you completely forgotten the last time I saw him? Yeah, that was five years ago.
Jamie had just found out that you'd been cheating on me with your partner's daughter.
It's a little over-reaction He broke my nose and then called me the most horrible person that he's ever met.
He shouldn't have broken your nose.
You know, texts, calls and e-mails all go to the same magic device these days, only got to send one.
Then it's even weirder it took you so long to get down here.
Yeah, it's a crazy mystery.
It's not like I got a department to run.
This other magic device tells me that lead poisoning wouldn't cause all my symptoms.
True.
But it could cause the 5% that are real.
You think I'm a hypochondriac? Well, let me answer this way.
Maybe you're imagining that I think you're a hypochondriac.
Look, my hand just started to shake.
It's a side effect of these arthritis pills.
Read the label.
I did.
When I was typing it up.
Right before I slapped it on a bottle of sugar pills.
You printed a fake label just to prove I'm a hypochondriac? Did it work? It got you fired, you schmuck.
An hour to convince her to go with Dr.
Kaufman, and only then because he runs internal medicine.
She wanted to leave the hospital entirely.
My God, a woman getting better wants to leave the hospital.
If she's getting better, it's not because you made her feel like a fool.
It couldn't be more because.
If I hadn't, she'd have diagnosed herself with six new forms of cancers.
She'd never leave.
It's hard enough dealing with my mom being sick.
This juvenile - Yeah.
- Lisa.
It's gonna be okay, but she's in A-fib at 170.
Oh, God.
I think we should cardiovert while she's unsedated.
I'll be right there.
A-fib's at 170.
Wait.
I'm sorry she's sick.
I'm not sorry I'm off the case.
You're not off the case.
You don't think you can convince her No, no.
You are staying on.
She just can't know about it.
Top of the morning, Dr.
Kaufman.
Here's the deal.
You copy me on all the imaging.
I'll have my guys run the lab tests.
No.
I thought you spoke to Cuddy? Yeah.
Then I spoke to the elder Cuddy.
Who specifically requested you not be involved.
Listen, Kaufie.
You are perfectly competent, bordering on good, even.
But you know I'm better.
If you want, we can pretend it's 'cause I got a team and more resources.
Either way, it'd be crazy to ignore my advice.
It's not gonna stop at advice.
You're gonna start cutting me out, go behind me to your girlfriend.
And if something goes wrong? It's still me standing up there alone at the M&M.
Please, stay away from my patient.
You bugged the room? I absolutely without apology will admit that someone may have allegedly done so.
Guess we can pass unethical and skip straight to illegal.
Not according to the recent Supreme Court case of Bite vs Me.
Dr.
Kaufman's single.
Did you know he went to Harvard Medical Mom, stop yenta-ing for one minute.
Of course, if you want gloomy and unable to commit, then stick with the goyishe one.
This is completely unethical.
Why are we listening to this? I know I'm a pain, but it's impossible for me to work with you if you Fine.
Fine.
Instead of a live stream, I'll get a recap from Cuddy 20 minutes later.
Thank you for saving America.
Could be leukemia.
Anemia from taking over the marrow.
A-fib from infiltrating cardiac muscle.
Sounds good.
Yeah.
I was really hoping for a different diagnosis.
One that Kaufman hadn't already come up with.
He just started a bone marrow biopsy.
So we don't need to do anything? I don't.
You do.
Go to admitting and find us a new case.
DDX.
We just did it.
No, we just did the fake one.
Why do you think I let the truth fairy know about the bug? I was testing her.
She failed.
She's still a narc.
Thiamine deficiency fits better than leukemia.
You think she's an alcoholic.
When I had dinner with Arlene, I mixed her a gin and tonic and I'd run out of the tonic so I substituted sleeping pills.
Next morning, she assumed the blackout was from the drinking.
How many old ladies are used to passing out from boozing? The answer is the boozers.
We're gonna have to slip her the thiamine pills.
We've got to run this by Cuddy.
Why do you think I'm in such a bad mood? Alcoholic? Treatment's very easy, safe, just literally a few vitamin pills.
It'll fix her heart and it won't interfere with the biopsy Kaufman's running.
I've put them in an antacid bottle.
Just tell her it's for stomach problems.
I have to ask her about this.
Of course.
Absolutely.
You'll ask, she'll deny, you'll push it, she'll get offended, you'll be exactly where you are now, except it'll be harder to treat.
You've absolutely got to do that.
I don't think she'll lie to me.
She just spent the last five years going south of the border down Mexico way.
We have our issues, but since Dad died, we tell each other the truth when asked directly.
It's important to us.
Addicts lie.
Can I speak to Mom alone? Why? You're scaring me, Lisa.
Mom, I think your drinking is causing your heart problems.
Is this about the champagne? She ordered Patsy and Anne told me last week you lost control at the museum luncheon.
You're talking to my friends behind my back.
We are all concerned.
Just tell me honestly.
How much have you been drinking? I may be your patient, but I am still your mother and I'm telling you I am not a drunk.
Okay.
For your stomach pains.
If something like that comes up again, just do what you need to do.
And keep you out of it? Yeah.
I am being a coward.
Which is exactly why doctors shouldn't treat their own families.
Congratulations.
You were right, as usual.
The hitting you was not optimal.
I was going through my own divorce at the time.
I've had years of therapy.
Now when I get mad, I do some deep breathing, squeeze my stress ball.
Hey, I kind of deserved it.
That's for sure.
Here's the deal.
I do a lot of med-mal insurance.
I need a new non-testifying expert.
I'll give you one case as a tryout.
You kick ass, I put you on retainer, average 15 hours a week.
It's 50 a year.
Fifty what? You kidding? Fifty thousand.
I'll take it.
You drive a soft bargain.
You got to sign an NDA.
Sure.
Is this That's a case I'm about to settle.
I rep a giant pizza delivery company.
Driver hit that kid, messed up his legs.
And gave him a micro-bleed in his brain, right? What? No.
This little white mark.
Your predecessor checked, so did the kid's doctors.
I don't know what that is, but he's fine.
Probably.
But if there's any doubt It's a multimillion-dollar case we're settling in two days.
Lay off it, okay? Okay, you're right.
I'm off.
She spiked a fever.
It's 102.
Means I was wrong about the thiamine deficiency.
You were wrong about the alcoholism.
True dat.
It's actually looking more and more like leukemia.
Kaufman rushed the biopsies.
It's not cancer.
So there's a bright side.
Kaufman was wrong, too.
DDX.
Okay.
What disease can turn Cuddy's mother into a coma patient named Stewart? Lupus? We got fired from that case.
We're moving on.
We were already fired.
By the patient.
This time by Cuddy, so it's real.
She somehow realized that her completely unworkable system was completely unworkable.
Okay, pop quiz, hotshots.
I chose Vegetable Stew for a reason.
You got 60 seconds, no hintsies.
You're not gonna talk to us? Exactly, you're gonna have to Hey, you're good.
So this is just a test? Pupils fixed and dilated.
An addict found with an empty bottle of phenobarb next to him.
How's this a mystery? It's an overdose.
Glutethimide! Script filled last year.
Could mimic fixed and dilated without the brain death.
Except he'll just get better on his own, so why would you take this case? Because House doesn't care about the treatment as long as the case is interesting.
I'll do a blood draw and put glutethimide on the tox screen.
- Really? - You thought that case was interesting? Guess we're still on Arlene.
Aren't there other ways of keeping Masters occupied? Not according to my sexual harassment seminar.
Maybe it's not hypochondria.
She says she gets a lot of rashes.
Add the fever, sounds like autoimmune, SLE.
Congratulations.
You can think exactly like a semi-competent internist.
Kaufman's starting her on prednisone.
But the heart problems were first.
Endocarditis? With no murmurs? It's usually a late sign.
The echo showed pristine valves.
Below the resolving threshold.
Kaufman's prednisone will suppress her immune system.
It could kill her.
You've got to tell him it's endocarditis.
Check the wiretap.
His ID guy's has been putting the same argument to him.
He can't convince him.
You think I got a better shot? So what do we do? We switch her meds.
We get a solution of broad-spectrum antibiotics.
Stick it in an IV bag marked for prednisone.
Kaufman can only be there a few times a day.
Tell Arlene you're from the pharmacy.
Switch them out.
This is nuts.
This is way too complicated It's hanging an IV bag.
If the attending doesn't know what she's on, the risk of What risk? We know how he's treating her, we bugged the room.
This is not about information.
We're talking ethical and legal violations on a scale that should make even you puke.
She's dying! Doesn't mean we should all go to jail to save her! You're losing control because this is your girlfriend's mom.
You gonna run this by Cuddy? No.
She said to keep her out of it, do what we need to do.
Look, I know what I'm suggesting is completely screwed up.
That's because this situation is completely screwed up.
Do it or you're fired.
We stick together, he can't fire all three of us.
Give me your prescription pad.
Why are you doing this? Because I think it's endocarditis and I think the prednisone will kill her.
And I forgot my prescription pad.
Am I a horrible person? I used to win awards for volunteer work.
I went to Guatemala and fixed cleft palates.
Now we're sitting back letting Chase do our dirty work.
We're doing the right thing.
Stay out of it.
I don't know.
I don't know about anything anymore.
Then this thing with the kid Rachel's brother is Stay out of that, too.
A, radiologists, experts, unlike you said no bleed.
B, you yourself said it's probably not.
C, you've got no doctor-patient relationship.
D, you'll lose your consulting job.
E, your ex will kill you.
F, I'm running out of alphabet here.
You do it? Had the bag.
Walking towards the room and Cuddy's sister says, "Hey, Dr.
Chase.
" I met her at that charity event last year.
One of you two's got to do this.
I met Arlene at the same benefit.
Conveniently.
Come on, don't ask me.
I don't even know if I believe it's Damn it.
It's Rachel's brother.
He wants me to check out some new case.
Conveniently.
It's a tryout.
I need this job.
I got to do this.
So you're just gonna ditch us, run off and work on some other case? Are you Timothy's mom? Yeah.
My name is Christopher Taub.
I'm a doctor at Princeton-Plainsboro.
I saw your son's file.
I think he might have a very small bleed in his brain.
Wait, you saw his file? How do you even know who we are? Your son could die of a brain hemorrhage.
He needs a cerebral angiogram today.
Get in your car and meet me at the hospital.
Timothy? We're gonna go see the doctor.
Another pop quiz.
How many idiot doctors does it take to switch an IV? The longer we wait, the more the prednisone is gonna kill her immune system.
Forget playing the pharmacist.
Mom naps every afternoon.
Wait by the room, when she falls asleep, get the sister out somehow.
Hi, Dr.
Cuddy.
Is now a good time to talk? Not really.
So, um, you know how you had us consulting, and then stopped having us consult? Why are you still here? Well, I think the stopping might have stopped.
House put me on this weird case where there's no treatment.
I think maybe to distract me.
And they've been acting odd.
I'll look into it.
Thank you for coming to me.
Because I'm worried that he's switching your mother's medications.
I checked with the pharmacy.
Dr.
Chase got prednisone and antibiotics for my coma patient.
Which wouldn't treat him, but could treat conditions that cause heart failure.
You told me to keep you out of it, do what I needed to do.
What the hell did you think that meant? I meant like if you had to slip her a few more vitamin pills or something.
This is life-threatening.
It's illegal.
I wasn't expecting something like this.
Only because you intentionally weren't thinking about it 'cause you don't wanna make any tough decisions.
Are you completely sure it's endocarditis? That's not a real question.
Endocarditis fits better than the alternatives.
We're having a little trouble hanging the right IV.
Fastest way is with your help.
Where did Julia go? She's got a family.
I've got a family.
Three kids and a husband, that's a family.
You are always tougher on me than Julia.
Why is that? I'm not.
I was thinking about when you made me run for yearbook editor.
I didn't want to, I didn't have a social life my whole senior year.
You let Julia do whatever she wanted.
We're debating 12th grade now? Like anything's changed.
What do you want, Lisa? Do you want to hear I love you both the same? Of course I do.
Okay.
But times like this, when we argue, it reminds me I have more in common with her.
She's nicer to me.
I love you both, but I like her more than you.
I called you three times.
My phone wasn't exactly on.
I figure I'll be getting some angry calls once radiology sends back the angiogram.
They already did.
Here.
This is what you saw.
It's an anatomical variant of the skull, bone in proximity to a blood vessel.
There was nothing wrong with him.
That was reason G.
That's good news for him.
Lungs clear? Diffuse wheezing, tightness, pruritus.
It's an allergic reaction.
Looks like.
But it doesn't make any sense.
She's on prednisone.
How could she get an allergic reaction? I switched out the antibiotics, put her back on prednisone.
Her breathing's normal.
But the A-fib's back and her fever's up.
Allergy's got to be due to our antibiotics.
Does Kaufman know what we did? That's good.
No, that is terrible.
He doesn't know that she got worse on antibiotics, so now he's thinking endocarditis.
He'll put her back on the antibiotics that almost suffocated her.
What do we do? We push through this.
Started in the heart, endocarditis still fits, it's just got to be fungal.
We have to switch Kaufman's antibiotics for Amphotericin B.
I don't know if you're right, I don't care.
But we are gonna end up killing this woman if we keep confusing her attending with these secret meds.
I don't care about confusing the attending.
I want this woman We're not talking about simple antibiotics anymore.
Amphotericin B is dangerous in itself.
It's a poison.
That's why it kills fungi.
It'll give her fever, chills Which she already has, which will help us hide it.
I don't think I can take a risk like that.
Well, then, you shouldn't have let her fire me! Look, all you have to do is switch the IVs again.
This has blown up on you once already.
He's right.
Yep.
I'm so sorry I got you guys into this.
You should go.
I'm right.
I know.
And I'll do it, but I agree.
Fungal endocarditis fits.
But we still have to tell your mother.
I don't want to tell her, not at all, but the patient is the highest priority.
I'm kicking you out of your office.
Yes, you.
This is not her office yet.
If you tell anyone, I will get you thrown out of med school and I will destroy your career.
I've thought about that.
Lying about me won't work.
Everybody knows your reputation.
True.
But I won't have to lie.
Buried in your coma patient's big, big file is a form that doesn't allow treatment without the express consent of the relatives.
Wait You drew blood.
That's not just a screw-up.
It's a criminal assault.
But you told me No.
As you may recall You set me up? Why? Because this patient is the highest priority.
You made her think I was hiding her son being sick! She scuttled the settlement.
She reported me to the bar.
I got to deal with that crap now! I will sue you for slander, for tortuous interference and anything else I can use to destroy you.
And my sister says, stay out of her life, you failure.
Five years of therapy.
Dr.
Kaufman, I need to speak with you and the patient alone.
I'm skipping the credentials committee.
I'm going straight to the state board and reporting you for What you've done is so off the spectrum, I don't know there's a specific name for it.
- I think he's talking to you.
- Marty, calm down.
- And you.
- What you did is worse.
He's an insane lunatic.
You're the Dean of Medicine.
I want you off my case.
That's exactly right.
Don't get excited.
You're fired, too.
What? I'll never get away from House or my daughter if I stay here.
Transfer me to Princeton General.
Mom.
You're very ill and you're very angry.
You really think now is the right time to make a decision like this? You lied to me and betrayed me.
Do you think I really care what you consider a good idea anymore? I'll get the ambulance.
Happy? I can't believe it.
What just happened? You just killed her.
Are you blaming me? This is all because you're so arrogant, you goaded her into firing you.
Actually, my mistakes started a little after that, when I agreed to your brilliant scheme to keep me on the case after she'd fired me off it.
She would have left the hospital.
Only 'cause you would have let her.
Like you did just now.
You think I can control her? I don't know.
I've never seen you try.
I have been rebelling against this woman my entire life.
Here's what I've seen.
She insults you, you complain to me.
I drug her at dinner, you never let her know.
We slip her medicine, happens behind her back.
You never confront her.
And it pisses me off.
Are you taking this personally? If she leaves, she dies.
One day, maybe a week from now, maybe a year from now, you're gonna decide that the man sleeping next to you killed your mother.
Get me my patient back.
This is really bad, Lise.
I swear to God, Jules, I will call security.
I asked you before why you were tough on me.
I wasn't.
You were.
And I know why.
You see something in me that you didn't see in Julia and you didn't see in you.
A type of ambition, a type of brains.
That's why you rode me.
You made me yearbook editor, summa undergrad, AOA in med school.
The only time I ever see light in your eyes is when you hear me talking about my job.
The reason you keep coming to see me in the clinic is because you trust me.
You trust my medical judgment.
So here it is.
If you transfer to Princeton General, you'll be treated well and you'll die.
If you stay here with House, you'll be treated badly, but you'll live.
I don't care if I have to slash the tires of every ambulance in this bay, Mom.
I am not letting you leave my hospital.
One, two, three.
I got it.
How are you feeling, Mom? I feel a little dizzy.
Heart's still weak from the infection.
We'll hang an antifungal IV.
If you're so great, how come you're not running your department anymore? What are you talking about, Mom? That's what he told me.
Two days ago? I said that I didn't have a department to run? I was being sarcastic.
No, you weren't.
Right, because people who are talking can't tell if they're being sarcastic.
That doesn't make any sense.
Of course they can.
But you weren't.
I love A-Rod.
He's so modest and I highly respect the paintings he has of himself as a centaur.
Question.
Do I like A-Rod? Yes.
Whoever he is.
She can't recognize sarcasm? Deficit in the right parahippocampal gyrus, which means CNS involvement before the fever.
I was wrong about the endocarditis.
I don't feel Mom.
Mom.
Heart rate 170.
Nurse! Do something.
I am.
House! The fever was hypothalamic.
That means brain, heart, anemia, allergy.
You hear that, what do you think? I don't know.
You think heavy metal toxicity.
It can't be.
You treated chelation for lead.
And she got better, then she got worse because she never stopped being poisoned.
What are you doing? You really want me to stop and explain? There it is.
Look at that.
The muscle's black.
Necrosis? Metallosis.
Her artificial hip weared and teared way too much.
It's cobalt poisoning.
We're gonna need Chase to get an OR.
We should start chelation again.
I thought you didn't want to see me.
I didn't.
But Foreman called me.
I didn't know that you thought that little boy had a bleed in his head.
I will kill my brother if he messes with you anymore.
What do you care? Chris.
You were a crappy husband.
But you are a good person.
Once again.
You are unfired.
Why? You sold me out even though you knew that you're gonna get thrown out of med school.
That's just kind of impressive.
I keep my job if I stand up to you, I keep it if I don't.
I don't buy it.
When Cuddy was protecting me before, she was protecting a doctor.
She's now protecting a boyfriend.
The hospital's not gonna put up with that for long.
So I need you to protect me from doing something Cuddy will regret.
See you bright and late tomorrow.
Mom, why would you want to keep this? So I can mount it on the wall like a moose head.
It says here, "Cobalt can cause rashes, "dizziness and stomach problems.
" You still think I've been imagining the whole thing? Okay, you might have a point.
How do you feel? You know, a little dizziness, some pain.