House, M.D. s07e15 Episode Script

House? House? Oh, my God! What the hell? Gotcha.
Did you actually wake up early and hide under the bed just to scare the crap out of me? Set an alarm and everything.
It's like dating a 10-year-old.
God, I hope not.
Now that we're down here Hold that thought.
Seriously? I have to pee.
I'll wait.
I brought a book.
Didn't know what time your alarm was set for.
House? You know, you could rent this space out down here.
In Japan, that would be like a deluxe House, shut up.
There's blood in my urine.
You really don't have to be here.
You're my girlfriend.
I'm being supportive.
I'm mainly talking about them.
Well, given that there's almost certainly nothing wrong with you, and my patient definitely has something wrong with him That can't wait an hour? Afraid not.
He's Chase? Sixteen-year-old male spit up blood during a pick-up basketball game.
ER couldn't find the source in his lungs or GI tract.
See? Serious.
Could be vasculitis, bronchiectasis, inhaled particles.
What about angiodysplasia? Ready when you are.
Get them out of here.
My urethra is not for public entertainment.
But it is good-time adjacent.
Feed the kid a camera, check his gut for angiodysplasia.
All right, scoot up here.
I'm missing a watch.
If you could keep your eyes open while Okay.
You, too.
This little camera transmits images to the data recorder so we can see if you've got any vascular malformations in your GI tract.
Your records show you've lost some weight over the past year.
Was that intentional? Not really.
Well, he's been eating less since he quit the swim team.
You have to get up early for swim.
It wasn't fun anymore.
I need to talk to your son about sexual activity.
Generally, it's less embarrassing for everyone We're leaving.
Actually, I've only ever How long have you been cutting yourself? Those are from a layback grind that went wrong.
Came off my skateboard, straight into a fence.
So, no to cutting but yes to appetite and sleep changes, and you quit something you used to enjoy.
How long have you been depressed? Imaging showed no sign of upper GI issues, but the kid did admit to being depressed and to smoking pot to take the edge off.
You are very pleased with yourself, aren't you? His marijuana could be laced with formaldehyde or lead, which could cause a pulmonary hemorrhage, which could make him spit up blood.
Yes.
Yes, I am.
It was a good catch.
Run a lead level and push five liters IV fluid.
Feel free to tip your other server.
Cystoscopy was clean, cytopathology was normal Why do you have my lab results? I don't.
If I did, I'd know you were fine.
Unless the blood came from my kidneys.
Come on.
Your hypochondriac mom had a brush with mortality last month.
It's understandable that you're worrying more than usual.
Worrying that you might turn into her.
You're right.
Odds are this is nothing.
Meet me in the cafeteria in 10.
There'll be a corn dog with your name on it.
I mean an actual corn dog.
They fixed the deep fryer.
I need to schedule an ultrasound.
My dad's head is still in one piece, so I'm guessing you didn't mention the pot.
What'd you tell them? The truth.
You had a minor chemical exposure and we can't be 100% sure how it happened.
Thanks for covering.
I know what it's like to be 16.
You also know what it's like to be depressed.
You figured out my deal after only a few minutes.
I've been fooling my friends and parents for months.
It's my job to notice things.
Maybe talking to your parents would make things better.
I've tried.
They take it personally that I'm not happy, and then I end up having to make them feel better.
They don't get me.
No one does.
In med school, it seemed like everybody else could handle the pressure.
I couldn't.
I ended up hurting myself.
Stupidest thing I've ever done.
You've got red spots in your eyes.
They weren't there before.
You have nice skin.
Thank you.
Shut up.
Sorry, just thought it would be rude not to comment.
Just treat me like any other patient.
Right.
Are you sucking in your stomach? No.
Now hurry up before I pass out.
Wilson? Ultrasound isn't definitive.
We should run other tests before Stop talking like a doctor and tell me what you see.
There's a mass in your kidney.
We still don't know why Ryan coughed blood, and now he's got small hemorrhages in his eyes.
Sounds like an acquired coagulopathy, which gives us a pretty wide differential.
Gets a lot narrower if we factor in his depression.
Oh, don't do that.
Mood swings can be a symptom of physiological illness.
Not talking to you.
Mood swings are also a symptom of adolescence, along with emo music and masturbation.
More importantly, his weight loss and sleeping issues started a year ago.
Infection makes the most sense.
He shoots hoops at school, showers in the locker room.
- I'm thinking staph or - Damn.
You don't think Not talking to you.
- Everything okay with Cuddy? - She's fine.
She's just too stupid to accept it.
Start him on nafcillin for staph.
All that's in the First Mutual safety deposit box.
The retirement accounts You're freaking out because of one ultrasound performed by an incompetent bonobo monkey.
As demonstrated by my sitting here calmly, going about my business.
Calling in a lawyer, drafting a will.
Okay.
I hacked into your on-line schedule.
Look, tests always show something.
Mass in your kidney could be a complex cyst, it could be benign I'm a single mom.
I need to set up a trust, appoint a guardian.
It's silly that I haven't done it before now.
But you're doing it now because you think you're sick.
The freaking out can at least wait until after the biopsy this afternoon.
The biopsy's not till tomorrow.
It's the first opening in the schedule.
For the Dean of Medicine, the first opening in the schedule is Oh, look.
Now! My worry isn't any more important than anyone else's.
Actually, it is.
But I'm not sick, right? Good point.
I want my stuff, asshat.
I told you, man, I don't have it here.
Hey, guys.
Everything okay? On my way out.
I'll see you later.
You want to tell me what's going on? My friend gave me some leftover Klonopin he had when he switched to seizure meds.
I sold them to Roid Rage for 80 bucks, but I landed in here before I could deliver, and now he's gonna rip my arms off.
How often do you sell drugs? It was a one-time thing.
I needed the cash, I had the pills, so I thought, "Why not?" It was a bad idea.
The pills are at my house.
I could have a friend go get them.
Give the thug his money back.
One time only.
I mean, if you're okay with this.
You have three kids of your own.
It's not even a question.
Of course, I'll be Rachel's guardian.
And House is cool with this? I mean, you guys We've only been together a few months.
It seems like a lot longer.
Probably because you've been talking about him for 10 years.
And by "talking," I mean ranting about wanting to smash his teeth in with a stapler for being such a jerk.
People change.
I'll get it.
That better be her.
Rachel Cuddy, you were supposed to be home half an hour ago.
Don't blame me.
He's the one who wouldn't run any red lights.
Mouth on that kid makes Mel Gibson sound like Nelson Mandela.
Where'd she learn that? I don't know why you're here, but I didn't do it.
What's the problem, Officer? She was shoplifting down at the mall.
Are either of you this girl's father? Nope.
But since her mom died, she's my favorite tax write-off.
Officer, you have my word, it won't happen again.
Because next time she won't get caught! It's no big deal.
Good for you.
You could have just assumed he was a drug dealer, but instead you took his word for it.
It's nice to finally see someone have a little faith in humanity around here.
Why would you do that? Ryan, you okay in there? I'm not sure.
I think I just peed blood.
Looks like peeing blood is the new black.
Peeing blood after a night on antibiotics means we can move on from infections.
Scoping showed no sign of a bleed in his bladder, which points to a kidney problem.
Probably some kind of mass.
A kidney mass wouldn't explain the coughing blood or the hemorrhages.
Antiphospholipid syndrome, on the other hand Makes sense.
But doesn't rule out a mass.
You think it's cancer? Mass doesn't have to be cancer.
It could be a renal hematoma.
But the patient doesn't have any other abdominal trauma.
He's not talking about the patient.
Cuddy has a mass on her kidney? It's probably just a complex cyst or angiomyolipoma.
It's a mass, not a mystery.
They'll do the biopsy, then you'll have your answer.
Just have to wait.
Patient admitted to using pot.
Who knows what else he's doing.
This could be heroin-induced nephropathy.
I thought you trusted this kid.
And then you pointed out how sweet that was.
If it were heroin, he'd be going through withdrawal.
Antiphospholipid syndrome's a better fit.
Start the patient on plasmapheresis.
While he's doing that, can I at least search his house for drugs? Have I ever said no to that question? What are you doing here? Pie-eating contest.
Cuddy's biopsy is in an hour.
You should be keeping her company.
Okay, you've been worried that your relationship is getting in the way of your diagnoses, you're protecting your patient.
Either that, or you're an ass.
Three, I hate the smell of death.
The chances of Cuddy having renal cell carcinoma I'm talking about our relationship.
She needs support and comfort, both things that I famously suck at.
Which will inevitably lead to You know what's good for that? Practice.
Doing it, I don't know, once.
I'm not gonna act like there's a crisis before we know there is one.
There's no proof that there's anything wrong with her.
There's no proof she's being stalked by ninja squirrels either, but if she's scared of them, as her boyfriend, it's your job to figure out how to help her feel better.
You're right.
House told me to keep you company.
Nurse told me to give you antibiotics.
Tell House I'm fine.
Hmm.
Tom Cruise got married.
Do you want me to quote from First Corinthians? Because I can do that.
As a Jew, I'm gonna have to decline that offer.
Don't know what you're missing.
Saint Paul was really on his game.
He'll show up eventually.
You don't actually believe that.
But I do.
All these years, he's never stopped trying to annoy me for more than 15 minutes.
Now he can't even walk into the room.
"Love hopes all things.
" What is it with you and this kid? He's doggie-paddling in a sea of misery.
I remember what it's like.
How far do you have to reach back for that memory? Last night? Sometimes I hear you in the living room watching TV at 3:00 a.
m.
That's when classic Doctor Who comes on the BBC.
Yeah, if only they had some device that allowed you to record them, watch them another time.
I'm just saying, don't think fixing this kid is gonna fix you.
Yeah.
We're on our way back.
Our patient lost all feeling in his right arm.
Look at this.
Chase? How'd it go with Cuddy? Chase? Good thing I brought my ax cane.
House, help me! I'm coming.
House, please! Looks like we've got company.
House! No! Are you okay? I was sleeping.
What could go wrong? Patient lost feeling in his arm while on steroids, rules out autoimmune.
So what causes bleeding, kidney problems and unilateral numbness? And a complete absence of any record of Cuddy's kidney biopsy.
She must've put it under a false name so I couldn't rush the results.
What if we had it backwards, and it's not a bleeding problem, it's a clotting problem? And there's no patient file created in the last two days for anyone having that procedure.
She backdated the file? That's very clever.
Hands off.
She's mine.
Clots could explain everything, including the numbness.
We should do an angiogram of his brain, see if we can find it.
House.
We're worried, too.
How sweet.
I'm not worried.
I just want to get the results so she can stop worrying.
Okay.
But in the meantime Do an angiogram.
And you two go to pathology and look at Cuddy's slides.
You just said you didn't know which sample was hers.
I guess you're gonna have to look at them all.
Bigger question, what's the deal with Taub? Just because House is too distracted to notice your distraction, doesn't mean we didn't.
Clots, angiograms, I'm focused.
The kid scratched out the faces of half his class.
You don't think that's a problem? It's not our problem.
Why is it anyone's problem? I violently executed my about five different ways in my mind.
I didn't want to kill anybody.
I just wanted to torture them slowly in my basement, preferably with acid.
You guys ever think about what you might do to House? Maybe it's no big deal.
Unless it is.
Somebody shot House.
What are you doing? Pie-eating contest.
I was going to send Chase to tell you what the obvious right thing to do here is.
But then I realized if you were too stupid to know how stupid that was, you might miss the irony.
You have to be with her.
Yeah, I get it.
She needs artificial support for an artificial problem.
She's fine.
Chase did an excellent job.
She doesn't sleep with Chase.
We don't know that.
Hey, eating pie in here.
House.
I'm not gonna tell you a third time.
Do not screw this up.
Because I really don't want to clean up the mess.
He was referring to the pie.
Fourteen patients with kidney biopsies.
I tabulated them against their urinalysis results.
Six men, three diabetics, one LCDD, one kid, two seniors.
And, by default, one Cuddy.
The biopsy was inconclusive.
The mass is near the center of her kidney.
They couldn't get a readable sample.
Means they'll have to remove the mass to know if it's cancer or not.
File says they're doing some imaging now.
Give the surgeon a better idea of what he's dealing with.
Can we order pizza? There's nothing in the fridge.
At least, not anymore.
What's happening with the patient? Angio showed a clot in a branch of his middle-cerebral artery.
We started him on streptokinase to break it up.
Although maybe we should've just played a few rounds of Savagescape 2: The Revenge, because that's obviously the best way to make someone feel better.
You keep talking like Wilson, your face will freeze like that.
However bad you think you're gonna be in that room, not being in the room is worse.
When she breaks up with you, you're playing by yourself.
Honey, I'm home.
Just in time.
The pot roast is ready.
It smells wonderful.
I cured all my patients, so I came home to spend time with Rachel.
And how was your day today? It was great, Ma.
I got 100% on my spelling test.
And 170 on my LSATs.
Your LSATs? You're eight years old.
We've been studying together.
It was supposed to be a surprise.
Well, that's wonderful.
I think Rachel deserves a treat.
No, thanks, Daddy.
It might spoil my appetite.
Well, who could that be? Delivery for you, Mrs.
House.
Happy 29th birthday.
I'm not 29.
You're not limping.
This isn't possible.
None of this is possible.
A girl can dream.
You run out of sugar? I got your scans back from today.
Yeah.
Okay.
What's going on? Imaging shows enhancing masses across multiple lobes of Cuddy's lungs.
That's what kidney cancer looks like when it metastasizes.
She's dead.
What's up, losers? I hope you're enjoying being alive.
Today's lesson, natural selection.
Excellent system, made us who we are today.
But then we invented seat belts and grocery stores.
Things that keep idiots and weaklings alive.
And let's be honest, most of you don't really deserve it.
Here's to the natural order.
Yes! Whoo! Copied from his flash drive.
Do I go to the cops? Yes.
"Officer, I'd like to report an assault.
"The victim was a pile of leaves.
" It goes on.
He talks about bombing his school.
Which you know because you stole his flash drive and broke into his house.
How's that gonna play? Ryan's not responding to streptokinase.
We don't have very long before the damage becomes irreversible.
So we either up his dosage, or go into his head and get the clot out.
- Where's House? - Hopefully with Cuddy.
She did just get some pretty awful news.
I called her.
She doesn't know where he is, either.
Have you seen House? No.
He left my place last night after you called.
No one's seen him today.
Any idea where he'd be? No.
And you're not worried about that? He's not good with bad news.
Yes, I'm worried.
But this isn't about House, it's about Cuddy.
She's the one who could be dying and he's trying to make this about himself.
I'm not playing.
Okay.
She still believes he'll show up.
He'll either get over himself and be who she needs him to be, or he won't.
We'd like to do an embolectomy.
We'll run a corkscrew-shaped instrument into Ryan's brain and pull the clot out.
Okay.
Have you talked to him about it? Yes.
But I wanted to see you alone.
I saw some videos that Ryan made a few weeks ago.
He's blowing up pipe bombs and threatening people in his school.
Oh, God! He was probably just messing around.
Our son wouldn't hurt anybody.
I'm not so sure.
I know this looks bad, but Ryan's a good kid.
He's had a rough couple of years since he started high school, but I really think he'll come out of it.
He needs help.
Maybe he does.
But this gets out, he'll be suspended, maybe expelled.
How about you focus on keeping him alive.
What are you gonna do? What do you think I should do? So you can do the opposite? There are kids all over the country doing dumb, potentially violent things, but the percentage of them who would actually kill anybody is minuscule.
So I shouldn't do anything? Hmm, while the odds are low, the fallout could be huge, tens or even hundreds of lives.
So I should call the cops.
Of course, over-identification with the subject could skew the calculation towards being extra protective or alternatively You suck at this.
Hate the statistics, not the statistician.
Give me a little more dye.
There's the clot.
It just disintegrated when you touched it.
What was that thing? I got a great idea where we should go.
I don't want to hear it.
You're gonna love it.
Australia's Finest.
It's a great karaoke bar in Newark.
I hate karaoke.
They've got every song by every Aussie artist, Midnight Oil, Men at Work, Olivia Newton John.
I do a mean version of Physical.
And the barbecued shrimp is amazing.
What about the fries? Hot, salty and delicious.
Talking about food made me hungry.
You had candy in my other dreams.
Means you're stressed at work.
All dream symbols mean you're stressed at work.
Or castration anxiety.
No.
I was hoping you'd figure out a way to handle all this.
Maybe you can't because you're still a child.
I can do better.
Might be too late.
House? I should have been here.
I'm sorry.
I knew you'd come.
What was that thing? And why did it just dissolve in the middle of surgery? And why is his liver shutting down? That thing in his brain goes away, the kid slips into a coma.
We've started him on lactulose, but at the rate his liver function is declining, he'll be dead in a day.
Should we page House? He's busy.
House can't do anything for her now.
We need him.
By his own logic Patient's blood tests were negative for barbiturates or acetaminophen.
He's not on a high-protein diet.
House couldn't concentrate on the case before she was dying.
You think he's gonna get in the game now? If you don't make it, I won't sleep with anyone for at least a month.
Make it two.
Bitch.
AIP can cause uraemia, tank the liver.
It causes abdominal cramping not abdominal bleeding.
Because fucosidosis was such a brilliant idea.
Guys.
Type 2 citrullinemia fits.
There are no signs of hyperlipidemia or pancreatitis.
Those can take years to emerge.
Closest we've gotten.
Start him on IV sodium benzoate to reduce the ammonia levels in his blood.
Run a genetic test for citrullinemia.
Hi.
Hi.
Guess who doesn't have cancer? Me.
Also, you.
Actually, you for sure.
Me House The tumor was benign.
It was an oncocytoma.
They got it out, you'll be fine.
Then what was in my lungs? Well, once they ruled out cancer, I remembered that your mom was allergic to antibiotics, so I had them test your blood.
Your IgE levels were through the roof.
Because the lung masses were an allergic reaction.
So, now that you're off the antibiotics, your lungs should clear right up.
And I brought you something.
Say hello to your tumor.
Oh! Wait.
There are so many things that I could be afraid of, and most of the time I manage to lock them up behind doors.
Then this happens.
All those doors just burst open.
You just figured something out about your patient, didn't you? Go.
Do what you do.
Take him off the meds.
He's got a staph infection.
You treated him for staph three days ago.
It didn't work.
Bacteria already in his system responded.
But once a door's been busted open, more just keep coming.
Oh, he's talking about an abscess.
I got that.
For the cheap seats, an abscess is a gooey little cream puff of infection that probably burst when your little pride and homicidal joy took a hard foul.
It's good news.
If we can find the door.
I think I know where it is.
What if these aren't from skateboarding? The kid has been blowing up PVC pipe bombs.
If he got hit by shrapnel, the body walls off the foreign object, which, because it's plastic, doesn't show up on imaging, and provides a perfect home for bacteria.
Antibiotics attacked the infection , causing pieces to break off.
Some hit the liver, one lodged in his brain and dissolved when Foreman touched it.
Once we drain the abscess, and remove the shrapnel, the antibiotics can do their job.
He'll be fine.
Which just leaves, what are you gonna do now? All right.
I put the rest of the soup in the freezer so you'll have some for later.
Thanks for everything.
Yeah.
Here you go.
I got it.
Okay.
Are you gonna tell Mom? So she can show up here to take care of you by harassing the housekeeper and criticizing your bathrobe? Yeah.
I think I'm gonna wait a few years.
Okay.
Oh, and I moved your sleeping pills back in the medicine cabinet, because I just worry.
Rachel always calls them candy.
You took Vicodin.
When you came to my hospital room that night, you were stoned.
How did you know? How did I not know? How did I make myself forget for months that you're an addict? My subconscious was trying to tell me you could never get through this without drugs.
It was a one-time thing.
It's not about the pills, House.
It's about what they mean.
I was scared because I thought my girlfriend might die.
No.
You don't take Vicodin because you're scared.
You take it so you won't feel pain.
Everything you've ever done is to avoid pain.
Drugs, sarcasm, keeping everybody at arm's length so no one can hurt you.
As opposed to everyone else in the world who goes looking for pain like it's buried treasure? Pain happens when you care.
You can't love someone without making yourself open to their problems, their fears.
And you're not willing to do that.
I came to be with you.
But you weren't with me, not really.
I wanted to be.
Well, that's not enough.
I can do better.
I don't think you can.
You'll choose yourself over everybody else, over and over again, because that's just who you are.
I'm sorry.
No.
No, no, no.
Don't.
Don't.
I thought I could do this.
Don't.
Please don't.
Goodbye, House.