House, M.D. s07e19 Episode Script

Cranial nerves.
On old Olympus' towering tops, a friendly Viking grew vines and hops.
Olfactory, optic, oculomotor vagus, accessory.
Causes of edema.
Alive.
Allergic Differential for swollen scrotum.
Theaters, English spelling.
Torsion, hernia Epididymal cyst.
S Syphilis.
Enough with the drilling.
We're third year, no more exams.
You don't have to face House every day.
And after today, neither do you.
Here's to no more coming home in tears.
It's kind of like coming to the end of an extreme roller coaster, even with the terror, nausea and whiplash, I'm a little sad that it's over.
Let's go.
You got your procedure log? Oh, I'm not quite done, I still have one more lumbar puncture.
It's due today.
Unless you wanna blow off becoming a doctor and get another PhD.
I know.
I'm gonna get it done.
I thought you'd have that thing finished, like, six months ago.
I've been busy.
Oh, come on, Cruz.
Let me do this.
I need it for my log.
Wait, you aren't done yet? I've been busy.
What's in it for me? The satisfaction that comes from helping out a classmate? How about cash? Have you talked to House? It's 6:00 a.
m.
He won't be in for a few hours.
I keep a roll of quarters in the car.
I just turned in my log, and guess what I saw? There's an opening in the diagnostics department.
House wants an intern? He's never had one before.
You got to figure.
He doesn't want an intern, he wants you.
Uh, you must be Dr.
Thirteen.
Remy Hadley.
Nice to meet you.
You're back! Hi.
Hi.
What the hell happened to you? Why did you lie about going to Rome? You'd lie too if you bottomed out and ended up in drug rehab.
Thank you, House, for respecting my privacy.
What a perfect reminder that I'm back.
I didn't even know you had a problem.
Loved ones are always the last to know.
Loved ones and robotic, estranged ex-boyfriends.
Our patient is Kendall Pearson, She's that Canadian kid who's trying to be the youngest person to sail around the world.
She collapsed yesterday during a practice run.
Luckily for us, cameras were there.
Her corporate sponsors want us to check that she's seaworthy before the clock strikes, "You're too old to set a record.
" Gives us three days.
You've still only got one, right? Uh, last day as a student.
Could be simple dehydration.
She told the Coast Guard she had felt dizzy.
Pulse and BP were normal at the time of the rescue.
It's not dehydration.
What about your internship, did you sign up this morning? Actually, I'm still deciding.
Maybe she had a seizure and that's what caused her collapse.
Coast Guard reports there's no sign of head trauma.
What about her back? Look, right before the collapse, she hit the small of her back on the railing.
Damage to the adrenal glands caused adrenal insufficiencies, which caused the collapse.
Nice.
Blood draws every 15 minutes for four hours, to track her cortisol.
Masters, there's no hurry.
There's no wrong choices.
At least, that's what they tell people who make crappy choices.
What's with the sudden interest in her future? You know, a blacksmith who spends this much time hammering out a new blade from raw Jell-O, he gets curious about who ends up wielding it.
No reason to be curious unless you're interested in wielding it yourself.
You want her to intern here.
And you're considering this? Before I make my decision, I still have one more LP I need to get, so, I'd like to go to the ER.
Thirteen, why don't you take Masters to do the blood draws.
You can remind her about all the perks of working for me.
Behind the deck, port side.
If her adrenal hormone levels are consistently low, we'll replace them.
You'll be ready to launch Thursday.
Great.
Inside cabin, facing the bow.
Sorry, K, I need to borrow Mom.
The sponsors? No, Couric's people kicking up a fuss about rescheduling the interview.
Uh, I can take over.
Ceiling of the galley.
Right.
The last time I was on a boat was my freshman mixer in college.
I didn't so much mix as hurl.
Too much to drink? No, I was 13.
And in college? Yeah, I know.
Weird.
I was thinking cool.
We'll be back for the next blood draw in 15 minutes.
Unless, of course, you'd like to stay and continue bonding over your lost childhoods.
Listen, I have a ton of prep work to do to be ready to launch.
Is there any way we can speed the tests up? Mmm, I'm afraid not.
Unless you're up for getting on a treadmill.
We could stress her body, see if her adrenals respond.
It would only take half an hour.
Hmm.
It's about an LP.
Go.
I'll handle this.
Um, Dr.
Cuddy, can I come by your office later? I'd love to get some advice.
Uh, I'm in meetings all afternoon.
Try me tomorrow.
Tomorrow This is my last day as a medical student, so I've got this decision to make, probably the biggest decision of my career, which means maybe the biggest decision of my life.
Although, I guess, if I get married House has opened up an internship.
You do realize, if you take it, he'll probably end up firing you again.
He's always hired me back.
And he'll continue mocking and insulting you whatever chance he gets.
It's certainly toughened me up.
You're trying to get me to say good things about him.
No.
I'm trying to make you make your own decision and leave me alone.
Working with House is great and it sucks, often simultaneously.
Most people can't work in that environment.
Question is, can you? Thanks, Dr.
Cuddy.
You paged me down here and now you're doing my LP? Got bored waiting.
It's been two minutes.
This is your 11th.
Fourteenth.
Listen, your roommate, is she hooking up with that resident? I gotta find House.
- Rehab? - It's a great cover story.
Now, I can't ever drink around those guys again, thus eliminating my main bond with Chase.
Save the attitude for someone who didn't just get you your medical license back.
Price you pay.
There's a chicken in your office.
No, there isn't.
You lied about rehab? Oh, great.
Relax.
She's completely honest but also completely boring.
Watch this.
Don't tell anyone.
Of course not.
You did an LP? Why didn't you page me? Oh, I'm sorry.
Did you want to do one of those? You should've spoken up.
You want the job or not? Um I After careful consideration, I have decided to accept your offer for an internship.
Great.
My department has a slightly different procedure log.
Uh, you forged the last one.
I only did nine LPs.
Do you know how to do an LP? Of course.
Do you know how to do nine LPs and say it was 10? It's time to grow up.
Turn that in, the job is yours.
Stop staring blankly and go.
No doubt something horrible has just happened to our patient.
Her hand turned completely blue during the treadmill test.
We put her on vasodilators, restored enough blood flow so she won't lose any fingers.
Rules out adrenal insufficiency.
Where's House? He said to meet him here.
His chicken's gone.
Probably on the balcony.
You knew he had a chicken? - How come - Down here! Loss of consciousness plus she's slowly turning blue.
Have we ruled out magical gum? Low cardiac output can cause both.
Patient possibly has cardiomyopathy, possibly caused by mercury poisoning from all the tuna fish she eats at sea.
Uh, why are you putting chicken footprints on the floor? That clever bastard Wilson got hold of an Australorp.
Hello.
The quietest and calmest of all the chickens.
Damn him! Mercury poisoning is out.
Red blood cells have normal morphology.
Raynaud's.
Vasospasm in the ulnar artery would explain the hand.
But not the loss of consciousness.
Cerebral vasospasm explains both.
Cerebral vasospasm makes sense.
Take Thirteen, give the patient a calcium channel blocker infusion in the basilar artery.
Masters.
Thought you were gonna turn that in.
I'm a bit busy with my patient.
You're not busy now.
Masters.
Still haven't turned in your log? Still haven't gotten my 10th LP.
I was thinking.
Maybe you should take House's internship.
First you act like it's the equivalent of volunteering to be water-boarded, and now you're supporting it? You're weird.
You make paper airplanes for fun and hang them from the ceiling.
You have a membership to the Einstein Museum and an overbearing obsession with facial symmetry.
It indicates freedom from disease.
We're biologically programmed to Point is, you rub people the wrong way.
But House is okay with your lack of bedside manner, he's okay with your willingness to argue any point, with anyone, even if they outrank you, he's okay with your peculiar fashion sense.
It's peculiar? House doesn't think you're weird, which is weird.
But good weird.
Is that a chicken? I think it's an Australorp.
I'm gonna go check on my patient.
Can someone please explain to me what House and Wilson are doing with those chickens? They have a bet to see who can keep a chicken in the hospital the longest without getting busted by security.
Advancing past the vertebral artery.
And why are they doing this? The place they bought them only had one pig.
I'm glad you're gonna be sticking around after today.
Really? You want me to stay? It's good to add a different perspective to the department.
Someone who still remembers there are rules other than House's.
If I don't play by House's rules, he won't let me in.
Find a way around them.
I'd have to lie to him, which is still lying.
Lying about a lie, that's practically telling the truth.
Catheter is in.
Start the calcium channel blocker drip.
Means I need another LP.
Luckily, I know where you can get one.
You good here? Let's go.
Decent stick, very smooth.
Sounds like you've had a few of these.
Suppose that comes with the territory.
I have Huntington's.
No need to get hushed and solemn about it.
Why are you lying about rehab? Because the real reason I was gone is not something I want to share.
Couldn't you just say that? Should be enough for Foreman and the others.
How long have you worked here? House's people have personalities that range from nosy to "Pardon me while I do this cavity search.
" Do you think there's room for someone who does things differently? No.
Not unless House decides that's what he wants.
During catheter removal, I got a good look at her cerebral midline.
Her pineal gland is calcified.
Case closed.
We'll start her on hormone therapy and ship her out.
I handed in my log.
On your way to do that, did you happen to stop and give Thirteen an LP? Thirteen's stiff gait, small pupils, and the raging headache she's hiding gave you away.
Yes, and I still broke a rule.
My rule.
I told you to defy the Man, not this man.
Why is it so wrong that I don't like to cheat? Can we go? No.
Not liking it is fine, not doing what you don't like makes you an eight-year-old and wastes your potential.
You want me to be like you, it's not gonna happen.
That's the last thing I want, 'cause then neither one of us would be exceptional.
You think I'm exceptional? Not anymore.
I can do my job without compromising.
No, you can't.
'Cause I'm not gonna let you.
Internship's gone.
It's time for Masters to say goodbye.
Enjoy being a surgeon.
You'll be fine.
Surgery.
Anatomy.
The branches off the subclavian artery.
VITamin C and D.
VIT.
VITamin.
V, vertebral, I, internal carotid.
Internal thoracic.
Internal thoracic.
T, thyrocervical, C, costocervical Martha M.
Masters.
That's me! I'm gonna be a surgeon.
Next! Welcome to your surgical internship at PPTH.
The senior residents stand behind you.
We'll all get to know each other soon enough.
Grab a donut and get to work.
We're out of donuts.
Then get to work.
Little oozing.
- Isolated the left subclavian.
- Suction.
- You gotta do better than that.
- Can't see a thing.
Push calcium chloride.
It will supercharge the platelets and increase the clotting.
Two amps of calcium chloride.
Tell the blood bank to send up three units of packed red cells.
The field is clear.
Nice.
Generally speaking, pledges aren't supposed to talk unless asked a question.
That's because, generally speaking, pledges don't have anything to say.
Um"KP.
" Is that patient Kendall Pearson? I thought she was discharged.
Mmm.
It's a House case.
I never know what that guy is up to.
I want you to scrub in on my lung harvest.
But it's my first day.
Yes, I know.
I was there.
Be scrubbed and ready in 15 minutes.
What happened? Last I heard, you were going home.
Kendall collapsed in the parking lot.
They're doing something called a sympathectomy.
She must have had a hypertensive crisis caused by neural overstimulation of her kidneys, so they're cutting the nerves.
It's like cutting the gas line to an engine.
Yeah.
Sounds like what Dr.
Taub said.
Said it's basic surgery but It is.
You should still be on pace for a launch in 36 hours.
Her mom's packing the boat now.
I'm supposed to pick up some dry ice.
But Nothing you can do for her here.
Um We're just trying to help our daughter reach her dream.
She's different.
So, you have to be different.
I'll make sure she's okay.
Thanks.
You can see the full lobular structure of the left lung.
- Bifurcate innominate artery.
- I've never seen one of those before.
Hold this, Masters.
Rib spreaders.
You guys okay if I pull a circulating nurse? We got a train wreck in OR 10.
You got it.
Proximal end attached.
Can someone take the retractors for me? Not really.
I have to use the bathroom.
I know you're a rookie, but you gotta be kidding.
- I'm not.
- It can wait.
I'm gonna have an accident.
Next one in line, grab it.
What's wrong? - Hypotension.
- Low cardiac output.
Float the Swan.
Don't you have your own surgery? - I took a break.
- I told them I had to pee.
You lied.
Small one but it's a gateway lie.
I care about the patient.
Another lie.
You care about being exceptional.
I told her dad I was gonna take care of her.
A third lie.
Welcome to the slippery slope.
- RA is 8.
- Equalization of pressures.
I think she has restrictive pericarditis.
Add that to a calcified pineal gland When is a calcified pineal gland not a calcified pineal gland? I realize technically it's never, but When it's a granuloma.
It's Wegener's.
We should start her on steroids.
- But she had a high CK.
- Wegener's wouldn't explain that Dehydration does.
Yes.
But the calcified pineal could be sarcoidosis.
You had me at, "I had to pee.
" But Thirteen's right.
Start her on three-fold immunosuppressants.
Masters, you want to fight me on this, fill out a consult form so you can stick around.
Welcome back.
I'm not back! I'll just be staying for this case.
You got really good at this lying thing.
Hope it was one hell of a whiz.
I ran into Dr.
House.
He requested a surgical consult for his patient.
House never asks for a consult.
Something about this case, he needed a little more help.
First day of your surgical internship, you want to be loaned out to another department.
Interesting career move.
Drop the form by my office.
Don't stay away too long.
I'm already well on my way to forgetting you.
How about I take both you lovely ladies out for a drink? I'd love to except I think you're a cretin.
And the last time she was at a bar was ballet class.
I didn't take Oh.
That's funny.
I'm gonna stay and run a few extra tests on House's patient.
This one lab value doesn't make sense to me.
You're back with House? Mmm.
Just this one case.
I'm not staying.
I would kill for a chance to work with him, like, literally skin you and wear you as a disguise.
You want yours extra crispy or original recipe? Chickens! You ever get sick from poultry? Um A few months ago, from this pheasant-in-a-can my dad got me as a joke.
You think that's why I'm sick? I think that can was chock-full of a bacteria called salmonella enteritis.
Likes to hang out in the bones.
Let me know if any of this is tender or painful.
This bacteria thing, is this good news or bad? Well, if I'm right, that means all you'll need are antibiotics and you'll be, well, shipshape.
Sorry, couldn't resist.
Did you always know that sailing was it for you, that it was the right thing? Didn't even start till I was 10.
And at first, I was not a fan.
Certainly there's plenty not to like about sailing.
But now that you're so into it Oh, no, there's still plenty of things I hate about it.
I hate being wet, I hate being cold, I hate eating nothing but freeze-dried food.
That's quite the endorsement.
Sailing is amazing but it doesn't mean I love every second on the boat.
Doing what you love means dealing with things you don't.
If there were nothing to overcome, it might not be that Ow! Salmonella enteritis is a nice catch.
- Thanks.
- Starting on the soft tissue windows.
Once this case is over, you going back to surgery? That's the plan.
I think that's a mistake.
I think you should go back to surgery.
I just said I was.
No, you said it was your plan.
Which means House might be right and you might be lying to yourself.
Would it be so terrible? You chose House over surgery.
And my time here changed me in ways that not everyone in my life thought was for the better.
No masses.
Moving on to bone windows.
Are those people right? I think when you do change, it's not so simple to go back.
There.
In the humerus.
Doesn't look like an infection.
That's because it looks like cancer.
You have a lymphoid sarcoma.
A cancer in the bone in your arm.
Am I going to be okay? It's a treatable cancer.
But part of that treatment involves amputating your arm.
I'm sorry.
There's nothing else? Um We can do chemo and radiation, after the amputation.
I don't mean after, I mean, instead of.
If I leave soon, I still have time to break the record.
Honey, you can't be serious.
I feel fine.
Last night, they thought it was an infection.
We know it's cancer.
We ran the biopsy three times.
You don't know how fast Postponing the surgery could increase the likelihood that the cancer will spread.
Kendall, you need to think about what the doctor's saying.
I'm thinking about this sail, like I have since I was 10.
Don't take this away from me.
It's just a month, I can take extra precautions.
I'll Skype you every day.
And I can fly back if something goes wrong.
She'll be risking her life.
I think we need to discuss this as a family.
You're considering this? Your daughter's condition Thank you, Dr.
Masters.
She's not budging.
She wants to launch tomorrow.
She's a minor.
You sign the consent form, we can do the surgery.
Amputation can be an emotional She's talked my wife into agreeing with her.
One parent's signature is enough.
She needs you to be a parent.
You're asking me to blow up my family.
I'm asking you to save your family.
On her first solo Atlantic crossing, she scheduled a court date to become an emancipated minor.
She'll do it again.
And she'll win.
She's gonna do what she's gonna do with or without me.
I'd rather have it be with.
I'm stuck.
No, you're not.
Case is over.
You're back to surgery.
Fetch! Who's a good boy? Who's a good boy? Good boy.
No one will stop Kendall's sail.
You need to step in.
Sign on the door says I'm a diagnostician.
Cool diagnosis means I'm finished.
She could die.
Pretty sure the law of the land states that everyone has the right to be an idiot.
I think it's the second amendment.
Fetch! Bring it here.
Good boy.
Who's a good boy? You are constantly railing against hypocrisy, forcing people to face the truth.
This time, nothing? Yeah, because they've faced the truth.
And made a decision that will in all likelihood kill their daughter.
I'm fine with that.
I wanted a diagnosis, I got it.
What do you want? I don't want her to die.
Break the rules.
I can't.
So coloring inside the lines is more important to you than saving this girl's life.
I was wrong about one thing.
You are not exceptional.
And fetch! Oh, ho, ho! Who's the good boy? Good boy.
Good boy.
Dr.
Wilson? I'd like to get your advice about a cancer patient.
Kendall Pearson? Oncology rounds.
Everyone's talking about it.
Ow! Are you okay? Yeah.
My back's acting up.
Oh.
Um So What would you do? I would keep trying to convince her to have the surgery.
And if she kept saying no? I would just keep Mmm Keep Keep trying.
I know there's a chicken under there.
Oh, thank God.
He already pecked through one pair of my loafers.
So, that's all you'd do? That's all you can do.
Is it? Isn't that House's chicken? Disgusting beasts.
I don't know why I ever agreed to this bet.
So call it off.
And lose $20? Listen.
House was in the exact same situation Kendall's in.
He needed surgery but he didn't want it.
Once he was in a medically-induced coma, his girlfriend signed the consent form as his proxy.
They went ahead with the surgery against his will.
Probably saved his life.
So, she did the right thing? Depends on who you ask.
Fetch! No! No! Excuse me! Who's responsible for this chicken? Does anyone know who owns the chicken? That bird belongs to Dr.
Gregory House.
You need to do the surgery.
I will.
Now.
We've been through this.
I'm leaving today.
It's a stupid record.
It's not about the record.
I used to race against other people.
I could have the slowest boat in the fleet and I'd win.
So it's about being better than everyone else? It has nothing to do with anybody, except me.
The other racers would think I was crazy.
I'd set off on some tacking angle that made no sense to them because they couldn't see what I saw.
I could sense the changes in the wind before they even happened.
At the top of the game, you play by different rules.
Medicine's gonna burn a little bit.
- Bradycardic arrest.
Third-degree heart block.
Likely a paraneoplastic syndrome.
Need to get her to the OR for a pacemaker and plasmapheresis.
What's going on? The cancer is causing her heart to slow down.
We have to get her to the OR and treat her.
This is what I was worried about.
If this had happened at sea, she would be dead.
Oh, my God! We need you to sign the consent form, authorize us to amputate her arm.
Subclavian access established.
- Temporary pacer ready.
- Don't need it.
Push calcium chloride.
It'll fix the heart block.
Bradycardia was me.
You did this? Her parents signed the consent form.
Amputate her arm.
What happened? You had a cardiac episode that required us to bring you into the OR.
That crisis resolved, but What did you do? What did you do? During the surgery, we found cancer in a lymph node in your neck.
So you cut off my arm? The cancer was already spreading.
It had to be done.
I told you I didn't want this.
If we had waited until after the sail was over, you would have died.
That record, that was everything.
It wasn't everything.
You have a life, a future You weren't supposed to do this! How could you? Because we love you.
I hate you.
I hate both of you.
Okay.
My arm My arm! Dr.
Masters.
Thank you.
Someone has got their pouty face on.
I did things no doctor in their right mind would do.
Good.
I manipulated, lied, forged, stole.
I don't want to know the specifics.
I might be called to testify.
I broke the rules because I believed I was right.
You were right.
Then why don't I feel good or satisfied? Instead I just feel like throwing up.
And you're following me to ask how I break the rules and maintain my rosy demeanor? I didn't do it to be happy.
I just thought I would be.
Well, you can't always get what you want.
To the victor, the spoils.
Your bird recover okay? Physically, yes.
Emotionally, it was a long night.
Next week, ferrets? House.
I can't do it.
I'm leaving.
Surgery? I don't know what I'm gonna do but I do know I don't want to be here.
Nothing will ever be simple again.
I'm fine with that.
Oh!