House, M.D. s07e16 Episode Script

One.
Don't tense up now, go with him.
Two.
That's it, stay in rhythm.
Three.
What are you doing, Lane? You're tipping in.
Four.
What's your problem? Get your ass down.
Get back in the middle.
Five.
You're weak, you've got all kinds of daylight under you.
Six.
Damn, Lane, you should be schooling this bull.
Seven.
Get up, set your hips before the kick comes down.
Nice recovery.
Now, just wait till he turns back away from your hand.
Whoo! Lane! Lane! What the hell just happened? I was about to ask you the same thing.
I'm fine.
Okay.
I assume Cuddy told you that she dumped me? She did.
And that I'm back on Vicodin.
She told me you had taken a Vicodin.
And then I took a lot more.
And so on.
But you're fine.
Well, I'm not fine as in fine, but I'm fine as in you don't have to worry about me.
Because you cleared out your bank account, checked into a hotel and started back on Vicodin.
Because I'm going to be fine, as in fine, very soon.
Until that happens, are you sure Vicodin is My leg hurts.
You've been able to handle the pain.
It's gotten worse.
Not physically worse.
Worse is worse.
Pain doesn't discriminate.
Neither do the pills.
The Vicodin and the five-star pampering that I'm going to get over the next few days should be enough to get me through it.
So, you don't want to just avoid the issue.
You want to avoid avoiding the issue.
Sorry.
Nothing is either as bad or as good as we think it is at the time.
It's why T.
O.
Mocks his opponents immediately after scoring.
He doesn't wait till his friend shows up the next day to tell him to deal with it.
Two weeks from now, maybe a little more, maybe a little less, my life will be back to its usual level of crappiness.
Till then, the only real issue is how much I'm going to spend on hotel charges.
Good morning, sir.
I've got your deluxe breakfast for two.
Do I have to count the strawberries? Don't worry, you can trust me with anything.
Including your food.
After he and I have sex, I'm going to slit his throat and then disembowel him in the bathtub.
No problem, I'll cancel the morning maid service.
Would you like me to have them clean up later when they come to turn down your bed? Why didn't I meet you six months ago? Thank you very much.
And if there's anything else I can do to make your stay here more enjoyable, just ring the concierge and ask for Carnell.
Eat fast.
We're expecting company.
Okay, this might not be such a bad idea.
What do you think he meant by "anything"? Take some time for yourself, relax.
I know it's a figure of speech, but he really did seem to underline the "anything".
Maybe, talk to someone? Already scheduled.
Really? I'm not an idiot.
I know I need help.
Okay, that's great.
I meant like a counselor.
I know.
But you meant a hooker.
Yeah.
Baby steps.
House screwed us.
Ten years of doctors cobbling him back together.
Metal rods in every limb, pin stabilizing his spine, five screws, and a titanium plate in his skull.
Can't do MRis, X-rays are probably going to be useless as well.
Every piece of metal is going to obscure something.
And House isn't sick.
Why would you say that? Cuddy dumped House.
He's out somewhere expecting us to indulge him while he ignores his job and licks his wounds.
Cuddy dumped him? Don't do that, don't get sucked in.
He loves her! What, you can't feel bad for him for five minutes? I can feel bad for him while still expecting him to act like an adult, show up for work and not go on a booze, Vicodin, and hooker-filled bender.
Which is why for now, we're going to handle the case without him.
Oh! Is that the reason? I thought it was because you can't pass up any chance to seize control.
I said "we", you want pretty please, too? Wait, I understand the booze and the hookers, but why Vicodin? Wow, you really don't have any friends in here, do you? House is a Vicodin addict.
He's been clean for two years.
He's used here at work? Yes, that is very troubling.
Almost as much as the fact that our patient has a ruptured diaphragm, cracked sternum, broken nose, and partial hearing loss, which can be explained by a bull jumping on him.
And a neurological disorder, low-grade fever, nausea, and peripheral muscle weakness that can't.
What if the hearing loss wasn't caused by the bull? That's just when he noticed it.
Inner ear pathology can affect the equilibrium and cause disorientation.
Making it appear to be a neurological disorder.
So how do we confirm? CT is just going to show us the plate and screws holding his skull together.
We can do calorics and an ENG.
If he has inner ear damage, it'll affect his balance.
Sounds good, go ahead.
Go ahead? Really? What if one of us disagrees? I happen to agree with Foreman.
Go do it.
You knew he was an addict before you got involved.
Didn't end the relationship You knew he was an ass before I didn't end it You told him you did not want him to change.
And I was wrong.
You don't know that! You thought you were going to die.
Do you really think that was the right time to make this kind of decision? No.
But I thought about it.
A lot.
I haven't changed my mind.
He thought you were going to die.
Nobody knows the right way to react in that situation.
Just give him another chance.
He deserves it.
I know.
But this isn't about what he deserves.
When things go wrong, I don't want to hope that I'm not alone, I want to know it.
With House, every time I needed him to step up It's just never going to be that! It's not his fault, it's who he is.
I should've known it.
This is my fault.
Well, he's back on Vicodin.
So you might want to keep an eye on his new patient.
ENG was normal, means his inner ear is Morons.
It wasn't Whoa, wait a sec.
The acoustics in here are beautiful.
Morons! You say it.
Morons.
Who was that? Something Carnell got me.
It wasn't that ridiculous of a theory.
Great theory.
It's a ridiculous test.
You can't give a standard balance test to a champion bull rider.
If you're going to test Superman's strength, you need a bigger barbell.
Find one, make him lift it, then call me, and tell me how high it got.
And tell Cuddy that spying is for cowards.
Just keep me posted.
I will.
I will.
You said my inner ear was fine.
Previous test was for regular people.
You were banged up pretty bad in the accident, but given your athletic ability Wasn't no accident.
That bull had malice and forethought.
Ah You mean afterthought.
Whatever, he was pissed.
Can you blame him? Not at all.
If he don't do what he gets paid for, I don't get to do what I get paid for.
Ever think of getting paid for doing something else? You're running out of bones to break.
You ever think of doing something you don't love? It has its downside, but everything does.
There ain't nothing like those eight seconds.
And traveling around getting to meet the fans, that ain't so bad either, if you know what I mean.
All right, now what? We're going to start rocking the platform and changing your visual field while you balance on just your right leg.
Here you go, Lane.
I'm going to start slow.
If you start to experience any nausea, disorientation, just let us know and we'll stop the test.
You got it.
Whoa.
That is amazing.
We can stop.
There's obviously nothing wrong with his inner ear.
Now what? And I direct that question not to my boss, but to anyone who has an answer.
If it's not in his ear, it's got to be his brain.
But if we can't get any images, then how do we You guys got some rusty pipes.
This water's brown.
That's not from the pipes.
It's from your mouth.
Can you pass me the What took you so long? There's nothing wrong with his ears, but he's got blood in his sputum.
Doesn't answer the question.
We weren't avoiding you.
It took us a little time to think up a diagnostic test no one's ever thought up before.
Apology accepted.
It could be a tumor in a salivary gland.
We should get a parotid biopsy.
Aww! That's so cute.
You're fighting over who's in charge.
GI bleed's more likely to explain the nausea and weakness.
Who's in charge? House, as long as you're not here, someone has to have the final Let me rephrase.
- Who's your daddy? - Let me rephrase.
You have to decide if you're going to buck up, get out of bed and do your job, or if you're going to wallow in self-pity.
Those my only two choices? Or can I also point out the self-pity coming from you? You're just annoyed because when your relationship ended, no one gave a crap, including you.
That is not true in so many ways.
And Chase? Stop screwing with Foreman.
And Foreman? No.
Until the telephone gets un-invented, no one in that room needs more authority than I give them.
And right now, I give you the authority to scope his GI tract and biopsy his parotid, then you can pick up the phone House, should we be more worried about you? Are you on Vicodin? Because if you are, you probably shouldn't be ordering procedures.
I am not on Vicodin.
Do the tests.
I have to see a man about a hurdy gurdy.
You really think House isn't using Vicodin? Does it actually worry you? If he's self-prescribing meds, that could affect his judgment.
And does that worry you? Are you being sarcastic? If his rule-breaking is affecting his judgment, then you can step in, then you can worry.
But if he's just coming up with ideas that we haven't thought of but we should have, then our job is to shut up and do it.
And what do you see in this guy? Hmm? What? Who? Oh.
You think I'm attracted to our patient.
Right.
It's against the rules.
So, you wouldn't do it.
He's a macho half-wit.
You have every reason to not be attracted to him, which is why I ask the question, why are you attracted to him? Stop it.
I'm just No, no, no, take out the scope.
I don't see any No, not the monitor, look at his eyes.
- Sclerae turned yellow.
- - Did x-rays, looks like there's a mass in his liver, but the conductive metal rod in his ribs is blocking it.
Making it, as they say, as tough to find as a hooker who can play the hurdy gurdy.
If you have a point, can you please It's an expression.
Means it's tough, but apparently it can be done.
We don't have any equipment.
You have eyes.
Not that see through stuff.
Obviously.
You want us to cut him open? Only if you want to see what's wrong with him.
Do you know Free Bird? Do you see what I see? No.
Exactly.
More suction.
That's impossible.
I definitely saw a mass in the x-rays.
It's gone now.
It's a mass, and then it's not.
You, uh, going to introduce us? Team, meet Duke.
Anke.
Anke? How'd I get Duke? House, how many prostitutes have you had? As in, eaten? Ever? This year? Slept with since you've been here.
All but one.
She did my taxes.
On the other hand, tape worm that burrowed outside his intestinal We would've seen eggs on a faecal smear or systemic eosinophilia.
Detached cysts? Couldn't migrate that far in one hour.
We haven't been sitting on our hands just waiting for your brilliance to kick in.
Okay, so how did you shoot down intermittently swollen lymph node? That would mean it's some kind of infection, which would mean we'd have to do a spinal tap.
But with his recent skull fractures, it could be increased ICP.
His brain could herniate.
What about a ventricular puncture? Sounds good.
You think sticking a needle directly into his brain would be less dangerous than sticking it in his spine? It's probably a push.
I'm just trying to get you out of here because underneath this sheet, stuff is going on.
Just pick a spot and stick a needle in it.
You want to drill through my skull because of a mass that's not there? It was there, which means something is wrong.
We need to find it.
Is there anybody you'd like us to call? Someone that you'd like to be here with you, maybe a wife or girlfriend? No, my family's all back in Oklahoma.
And the guys in the circuit are in Calgary at the next rodeo.
Ah! That's too bad.
It's nice to have somebody nearby you can talk to who cares.
You okay? Hmm? I'm just saying, it's good to have somebody nearby to talk to, who cares.
Okay, fine, I like him.
So what? No kidding.
I just can't figure out why.
Neither can I.
Looks clear, nothing to suggest inflammation.
Something's wrong.
O2 sats are plummeting.
We need to intubate.
Drop the table.
I can't get it in! The airway's blocked.
Get the trach kit.
O2 are going back up.
What's that smell? Did he defecate? Doesn't look like it.
I think it's his feet.
Oh.
Oh, man.
Oh.
Oh, it's definitely his feet.
Please, don't.
That is a nice bow.
That was a nice door.
Put it on my tab.
What say we take it up a notch? - Yeah, right.
- Very funny.
You don't trust me? No! I'll do it! And we have a gamer.
Oh, come on, man.
You can't be serious.
Why not? Anything goes wrong, we just take her to the doctor.
And I'm only eight paces away.
House I like you, Carnell.
Don't ruin it.
Stinky feet, could point to diabetes, athlete's foot or gangrene.
- Pick one.
- No! None.
None of those cause bloody sputum or disappearing masses.
No, no, no! No! You're going to kill her.
Don't do that, Carnell.
They might get the idea that I'm shooting at a hooker.
Fungal infection cause ulceration between the toes.
Bleeding can be from recurring abscesses that appear to be recurring masses.
Symptoms in the head or feet mean the infection would have to be in the heart or the brain.
I say we start by looking in the heart because looking at his brain with a metal plate is problematic.
So is MRl-ing his heart.
He's got a seven centimeter conductive metal rod holding his rib together.
- It'll rip him in two.
- No, it'll just feel like it's ripping him in two, which is much better.
We could minimize the damage by injecting ice-water into his abdominal cavity.
No! Please, no! Oh, God! Oops.
Got to go.
Call an ambulance! Why? What do you mean, why! She's hurt! She doesn't look hurt.
No, you didn't.
Yes, we did.
You're an ass.
Okay, go get me General Patton's Colt.
45.
The one with the two notches.
He's not getting you a gun.
Your friend knows how to have a good time.
The MRI magnets are going to heat the metal.
It could get to over 300 degrees in 15 seconds.
Which is why we're injecting ice-water into your abdominal cavity.
You'll feel colder than you've ever felt.
And then you'll be hotter You'll feel hotter than you've ever felt.
We'll try to be as quick as possible.
Why Shut up.
It's interesting.
No, it's not.
It's mundane and simple.
He's obviously a very blessed specimen, so from an evolutionary point of view, he'd produce healthy off-spring.
So my pre-frontal cortex is telling me I should have sex with him.
Oh.
Is that all? Yes.
My rational brain knows he's a hillbilly and an idiot.
And yet somehow your rational brain is losing the argument.
Which is interesting.
You were bored.
You must have spent about two days setting up a fake murder, and you were bored.
I'm fine.
You're not.
And I'm worried you might do something even stupider.
Why don't you move back in with me? At least until you get back on track.
What an ego.
You think you're some sort of emotional paragon, you're my rock.
I'm trying to be a friend.
At least I had the good sense not to marry every woman I fall into bed with.
Maybe you should move in with me.
Either way, if you prefer I prefer you to stop talking about this.
House, we haven't even started talking about this, except to establish the fact that you're fine, which clearly you aren't.
Leave me alone! No.
We are going to talk about this, and we're going to deal with this.
So I have no choice.
Fine.
Unless Unless Yes! I do! I do have legs! I see you didn't factor those into your brilliant plan.
Lane, can you try to hold still? I'm trying.
Real hard.
Guy is tough, I'll give him that.
My pre-frontal cortex is a little aroused.
Just get the damn picture.
Rib temp is at 158.
I don't have a clear view of his aorta yet.
This isn't going to work, we have to stop.
No, you're trying to protect him instead of trying to save him.
He's smoking! Literally.
You ass! Five more seconds.
No! Getting a good image isn't going to mean anything if he doesn't have a rib cage.
Got it! The images, they're normal.
You're going to have to talk to him eventually.
He needs you.
I love him.
And I know he loves me.
But I just can't He needs you in his life.
Even if you're not sleeping with him, he needs you.
Without you You can't go backwards.
I can't fix his problem.
I am his problem.
If the infection is not in his heart, it's in his brain.
You're in my sun.
Do a CT.
We can't.
He has a titanium plate and a bunch of metal screws.
Get rid of them.
His skull has multiple hair-line fractures.
Removing the metal plate will be like removing half an eggshell without cracking the rest of the shell.
And not removing the plate will be like leaving the egg out to rot.
We can't cut off the top of his head based on a few symptoms that disappear whenever we try to test for them.
What if the one symptom that hasn't disappeared, was never actually there.
Any delays when he answers questions? He doesn't have partial hearing loss, he's missing moments.
He reported having something like a complex partial seizure during the bull ride.
He said it hadn't happened since, but what if he's wrong? What if the infection in the brain is causing it to happen all the time? His EEG didn't show any sign of seizure activity.
I didn't say it was a seizure, I said it was something like a seizure.
I'm guessing you're about to tell us we need to find something like an EEG to prove Nope.
Because I already got one.
You want me to sing? How's singing My Bonnie going to help you see inside my brain? It won't.
This is going to prove that we need to cut into your skull.
Which is going to be kind of dangerous, so you've got a real incentive to sing like an angel.
We think you're having mini black-outs, but your brain compensates.
It can't compensate if there's a pre-set rhythm.
One, two, three.
My Bonnie lies over the ocean My Bonnie lies over the sea My Bonnie lies over the ocean Oh, bring back my Bonnie to me See? Told you.
Lane, that wasn't even close.
That was brilliant.
Yeah.
It's understandable.
I hate when you do that.
You respond to what you think I'm thinking because you think that I think like you do.
It's insulting and annoying.
You're scared because nothing excites you.
Fun doesn't excite you.
Puzzles don't excite you.
What's left? And I was saying, you're right.
You're upset, you're depressed.
Everything's going to taste a little worse right now, but it'll pass.
It's understandable.
You're scared because you think I'm falling apart, and you're trying to convince yourself that you're overreacting.
Keeps ringing.
Yeah.
House, there's no infection in this guy's brain.
CT's clean.
Well, that sucks.
Now we're going to have to blow up his heart.
We're not blowing up his heart because we've ruled out his heart.
MRI and transesophageal echo reveal no swelling, no masses, no vegetation, no sign of anything.
Because we're looking the wrong way.
There's an imperfection.
How do you find where? I don't know, I'd get a magnifying glass You suck.
Feel free to interpret that both ways.
You suck on the straw, see where the drink leaks.
So you're saying we put pressure on his aorta until it rips open? You do realize the downside of that? If we don't rip it, the damage from the infection will.
Probably not when he's got his chest open in an OR where it can be repaired inside the 60 seconds it'll take him to bleed to death.
It's a ridiculous idea, it won't work.
If you don't mind, I have to go get this guy's approval to rip his heart open.
Hey.
We think you have a Bartonella infection, which caused a mycotic aneurysm in your aortic wall.
We need to find it, which means we need to blow up your heart.
And yes, I'm as serious as a heart attack.
We're going to increase your blood pressure until the weak spot in your aortic wall explodes.
Hopefully we'll be able to fix it before you bleed to death.
Any questions? No.
Really? You don't even want to know if you'll be able to go back to bull riding? I assume no.
I mean, you've already cracked open my skull, and now you're going to blow up my heart.
I thought you loved those eight seconds.
I do.
And now you're telling me that I got to give them up.
I can always find something else to love.
House.
We need to talk.
You didn't expect me to say yes to rupturing his aorta, did you? Since I didn't ask, I wasn't expecting you to say anything at all.
You have no reason to believe this will save his life.
Really? No reason.
None at all.
I'm just planning on cracking open his chest, blowing up his heart, what, to pad his bill? Or you think that since you broke my heart I want to break his? I don't know.
I think maybe you're looking for something that can excite you, fill a void.
And it's affecting your judgment.
You're right, I am.
But my damaged, depressed, drug-addled judgment is still better than yours or any other doctor in this hospital.
And my team is going to do this procedure and save his life.
So, you can either have security arrest me and my team, or you can get the hell out of my way.
And she caves.
Rib spreader in place.
Heart looks good.
Aorta is exposed.
I take it you ratted me out to Cuddy? I think your judgment is compromised.
No, you don't.
Come on, I got a squash game at 2:00.
Let's give this cowboy a ride.
If I inject more, there won't be any room for the blood to go through the rest of his body.
You're right.
Just make damn sure we don't damage his toes while we blow up his heart.
No bubbles, no bruising, no gaps.
It's not working.
Yes, it is.
I was wrong.
Not yet.
Let's switch him over to bypass for debridement.
Come on, we don't have much time.
Slow the heart down.
Damn.
You can't clamp the aorta at this pressure, even if we can see through all the blood.
- Do it anyway.
- We need suction and more sponges.
The leak is too fast.
No, it's not, we can fix this.
It worked.
House, it worked! I heard you.
Hey! I'm awake, so I guess it worked.
As long as you don't get your heart rate too high.
You probably shouldn't have sex for a while.
I'll keep that in mind.
Want to hang out, see your ranch some time? Uh.
That'd probably be inappropriate because I'm your doctor, and everything.
Good luck with everything.
It Double Scotch, doubled.
Blended, single malt, any preference? No.
Yeah, sorry about the noise.
I guess their team won.
Although, I got to tell you, sometimes I wish I could still act like that, you know? Just let loose? I guess it's a little easier, though, when you got no troubles.
Parents still paying your bills.
You got your whole life ahead of you.
No! Cannonball! What the hell are you doing? What do you do when you win? Party! What do you do when you lose? Party harder!