House, M.D. s08e02 Episode Script

Get up, House.
Must be some mistake.
I specifically requested my wake-up startle three hours from now.
Some VIP visitor.
Dean of Medicine from your old hospital.
I've had dreams about this.
I'm gonna assume this is another one.
Get up.
I can refuse to see any visitor I want.
Tell the Dean that I don't want to see her.
He said you'd say that "He"? What's the hiring policy over there? All ass-based? I can get you out of here.
Not unless that file has a file in it.
Judge's order for your immediate release.
I had eight months added to my sentence two months ago.
The math is pretty basic.
We have a crisis.
Which is good news for you.
You're out tonight on conditional parole, the condition being that you're employed by me at PPTH.
No, thanks.
You think it's a good idea for me to go right back to my old life? For either of us? Your patient is two lungs in a box.
It only has 12 hours left.
No pulse, no body, no ability to answer questions.
It's your perfect patient.
I did pay for the room for the whole week, but Donor's an 18-year-old college kid back from Hofstra.
Goes to a homecoming party with his buddies, hops on his motorcycle, ends up an organ donor.
Asystole in the ER.
No pulse.
No blood circulating.
His heart, liver, kidneys were all toast.
Surgeons had the recipient on the table when they realized the lungs had increased airway resistance.
The team closed her up, put the lungs in suspended animation.
Buys 24 hours to fix it, And we still have no clue what's wrong.
Nice painting.
Blues and greens.
Calming with a hint of nurturing.
Totally offsets the stench of suffering and death.
Where's my patient? We need to not talk.
ICU isolation room.
The transplant team will meet you there with updates from the past two hours.
Great.
Take this.
How about you drop it in your office? I completely understand and almost respect your desire to appear to be Dean of Medicine given that your title is Dean of Medicine.
On the other hand, seriously? Get this straight.
You break the law, you go back to jail.
Scam extra Vicodin, back to jail.
Flout my authority, make the hospital look bad, back to jail.
I own you.
Yes, master.
See, that would be an example.
When did Cuddy leave? She gave her notice the day after your incident.
Took a job Don't need the details.
Ortho needed more space.
You're this way.
Where's my stuff? No idea.
What about my team? Pathetic.
The first thing you said to me was you don't want your old environment, the fourth thing you said was, "Where's my old environment?" It's been a year.
Taub, Chase, Thirteen all moved on.
The world does that sometimes.
No, it doesn't.
Here's your new office.
And there's your new team.
Hi.
I'm not interested in another department's sloppy seconds.
I'm not sloppy seconds It's 3:00 a.
m.
If Foreman had called you in from home, you wouldn't have pressed clothes, coiffed hair and make-up.
Which means you were already here in the hospital.
Yes, I was on-call for Neurology.
If that were true, you'd be working right now and unavailable to help.
Which means that you're hanging out in the hospital pretending to work.
Which means you're not just a reject, you're a cowardly reject who's trying to hide her rejectedness from someone.
I am not a reject.
Then go back to Neurology.
I can't.
I punched my attending.
ARDS secondary to trauma is our leading hypothesis.
FI02 is 93% Prison! Sorry, I thought I heard everyone else think that.
I was in prison, see? It was a long time ago, but still, you're curious.
Never was raped.
Not raped-raped.
Well, raped-raped but not raped-raped-raped.
Well, now that we've got that completely behind us I'm sorry.
Dr.
House, welcome back ls there cake? Any alveolar exudate? No.
Lungs are dry.
Well, it's not ARDS.
It's the autumn.
It's tick-borne disease season.
Ehrlichiosis causing bronchiolitis.
You'll appreciate that I left the "idiots" subtextual.
Blood smear was clear, and we idiots treated with broad-spectrum antibiotics.
- Cocaine.
- Tox screen was clean.
Dead men don't pee.
Tox screen tests for metabolites in the urine.
Coke never got past the lungs.
Also explains the motorcycle crash.
Idiots.
Let's get the lungs on treatment.
Great idea, unless you're wrong.
And by you, I mean me.
Then this treatment will bum holes in the lungs.
I'd call you idiots, but at this point, I'm starting to doubt whether you understand what I mean by the word.
Kato, get Black Beauty and meet me out front.
We're gonna find the dead kid's stash.
Since an 18-year-old with organ donor on his license is not a cancer patient, I'm figuring the recipient is a lifetime member of the Wilson Cares Too Much Club.
Excellent deduction.
You're the reason I'm out of the big house.
Doesn't quite make up for never visiting, but Springing you was Foreman's idea.
I wasn't convinced until Simpson failed three times.
Amounts to the same thing, you wanted me back.
See, I knew you'd over-interpret it.
Strong, emotional reaction.
I guess that's what lifetime membership gets you.
How's your wrist? Healed, thank you.
I was wrong.
I went to prison I paid the price.
You're a changed man.
I said I was wrong, I didn't say I changed.
I haven't.
Neither have you.
Which is why Analyze it however you like.
We're not friends anymore.
What can I do? My chest Angina's back.
Upping the nitro.
Should knock it back down.
Sis and I were talking, trying to figure out how many hospital sleepovers we've had.
Definitely started with the Great Mastectomy of 2001.
God, I miss my boobs.
They were spectacular.
Is there a chance of locating another donor? It's unlikely, especially since with the extent of the emphysema, she needs a double lung.
How you doing? Better already.
It's a good thing that worked or I was gonna make you bring me a bottle.
Lighten up, Sis.
Least you could do is laugh at a dying lady's jokes.
Your drinking wasn't funny then, okay? And it's not funny now.
Because you're not dying.
The hospital brought in a consultant to work on the lungs.
Do you know him? Is he good? He is an excellent doctor.
We probably shouldn't be turning up unannounced like this.
Their son just died.
Bright side, they're probably up weeping.
Hey, we both assaulted our bosses.
It's like we're twins.
I'd really rather not discuss Okay, I'll go first.
My boss dumped me.
And yours, what, called you his china doll? Joked about what a crappy deal you got for Manhattan? Assumed that you have a huge penis? I have no idea what flavor you are, so I thought I'd just cover the spread.
My mom's Filipino, Dad's Korean.
And my boss grabbed my behind.
Behind what? Oh, yeah, your Grabbed your tushy.
So now you're pretending to be on-call so that your overly protective boyfriend won't find out you got groped.
I don't have a boyfriend.
It's my parents.
If they found out what I've done, they'd be mortified.
Your parents know your call schedule? I live with them.
Right.
No issues there.
I told you' my son didn't do cocaine.
Druggies are not known for their honesty.
Trust me on this one.
Mr.
Weathers, I'm sure you're right, but we need to be thorough.
Did your son ever smoke marijuana? He was an athlete, took real good care of himself Hey.
Take it easy.
Steve loved all that Sorry, but we're on a clock.
I think he's about to throw us out.
Nope.
His son is dead.
The only way that has any meaning is if we fix the lungs and transplant them.
It doesn't matter how much we piss him off as long as we find something.
So go back there, piss him off and find something.
Do you know any of the kids at the party with your son? A bunch of his high school buddies, they'd gotten really into poker, decided to have an all-night game in Brandon Broome's basement.
Hey I understand we're in a hurry, and that he's probably not gonna throw us out, but maybe he should.
Your son isn't wearing glasses in any of these pictures.
He just got them a couple weeks ago.
Because he was having headaches? Answer the question before answering the door.
Yeah, he was.
You're right, he was not doing cocaine.
He had a brain tumor.
Don't bother, it's for me.
Turns out they monitor these monitors.
Thank you, Officer.
I thought the bracelet was decorative.
My aunt had one just like it.
Wait a minute.
You're allowed to be at the hospital, you're allowed to go home.
That was made clear.
The dead kid's house was on the way to my apartment, assuming I got lost twice.
Those consultants in my office are only costing the hospital 100 bucks every minute I keep them waiting.
Why didn't you just tell me what you were doing? I knew you were very busy being vaguely important.
I might have cleared it with the cops.
Yeah, it's the word "might" that bumps me.
I'll run it by you next time.
House.
Getting you out of jail was not a popular decision with the board.
I need you to solve this, and I need you to do it without making me look like I can't control you.
For both our sakes.
Disciplinary hearing should be fun, and the subsequent lingering black mark on your record.
I'm not worried.
We have to wheel this out to the MRI.
We should probably leave the body in the bag.
There's a mass in the arm.
Analyzing part of this tumor is gonna be quicker than a scan.
So, where's the next job? You worry about what people think of you, thus the carefully maintained hair, clothes and parental secrets.
The only way that you're not worried about this hearing is if you don't think there's gonna be one.
The only way that happens is you leave Princeton-Plainsboro.
I had a video interview with Chicago yesterday.
It went well.
My money's on rhabdomyosarcoma.
Chicago has a great program.
And you're a dumb-ass.
Running away from home is a time-honored tradition.
But you're not doing it to flee your parents, you're doing it to protect them.
That's an insult to everything teen prostitutes have worked for.
Time to grow up and come clean.
You're right.
I should just drive my car into their living room and tell them.
Didn't it turn out that he'd stolen the hot dog cart? No, borrowed.
Bobby was very insistent on that point.
Seems like someone's feeling better.
No more chest pain.
I haven't heard the name Bobby in a long time.
How's he doing these days? I don't know, we're not in touch.
And don't even pretend like you're not relieved, you never liked him.
Bobby is an incredibly fun, great guy, just not a great influence.
I would have gone with colossal drunk.
I was gonna leave that implied, but yes, colossal drunk.
What? It's good for a couple to share a hobby.
Your catheter bag is empty, despite taking in 200 cc's of fluids.
I'm gonna have to dial back on the nitro.
Won't her chest pain come back? We don't have any choice.
The nitro is dropping the blood flow to your kidneys.
They're shutting down.
This is so our song.
My patient is running out of time.
Not worried.
My team is confirming the diagnosis as we speak.
I want to be understanding.
It's your first day back See? I smell empathy.
Just remember all the good times.
Like when I gave you that necklace that you just dumped in the ocean.
What were you thinking? House, I haven't forgotten our friendship.
For every good memory, there's a slew of bad ones.
Come in.
Come in.
Paraneoplastic syndrome is out.
The lung donor didn't have cancer.
You tell that to the tumor that I found in his arm? That mass wasn't a tumour.
It was coagulated plasma.
ER pumped him full of it, IV leaked into his arm.
I even did a complete MRI.
No cancer anywhere.
We've got nothing.
Just 'cause it wasn't a tumor doesn't mean it didn't mess with the lungs.
They're reacting to something in the plasma.
But every unit of plasma can have up to 25 contributing donors.
We'd need to track down all of them.
Still.
Not as bad as 1,000 people going down in a gigantic boat, right? My heart will go on.
No.
You can't leave the hospital.
Twenty-five donors contributed to the plasma that the lung donor got.
My "team" cannot track down and interview them all in six hours.
I vouch for you to the cops, you take some parole-violating detour celebrating your freedom, justified, of course, by some absurd theory connecting it to the case.
You asked me to ask you.
Was that just so you'd enjoy saying no? I don't trust you, House.
I can't.
Actually, you have to.
Not absolutely.
Not outside the walls of this hospital.
Fine, then give me a team I don't have to put in quotation marks.
Use the people already on the case.
Get me Chase, Taub, Thirteen.
We don't have the money to pay them.
Oh.
Yeah, it went to interior designers, I understand.
You only have Park because she's on Neurology's tab.
You are making minimum wage.
I am? Get out of my office, please.
What you got? Number three went to a baseball game the day before he donated.
Boredom is not transmissible.
He ate a bag of peanuts.
And peanut proteins would be.
If our donor had an allergy, could explain the lungs.
Nice.
- What? - Nothing.
Don't start that Start what? I'm enjoying our conversation.
The repartee.
There was no repartee.
That was repartee.
I'm not doing this for you.
I'm doing it to help my patient.
It's just good to hear your voice.
Good bye.
That's my whiteboard.
I need it.
And he really doesn't care how the cast comes off.
Dr.
Foreman warned us that you'd try something.
Told me to call him if you did.
I'd like to do that I'll take this outside.
Yeah.
Donor six traveled to Thailand, around Korat.
Region was endemic with dengue fever.
Good.
- Yeah.
- Alcohol.
You'd have to be pretty drunk for it to affect a pool of plasma.
These guys have got that covered.
Acute ETOH ingestion could have Hey! Paint around them.
They're not hurting anyone.
Who's painting? The crew is just starting.
The paint fumes didn't cause contamination.
But maybe the old paint did.
They scraped off the underpass, probably because it contains Lead.
lead.
Chest pain back? It's worse this time.
Is there any way to take the edge off? We're still working on the lungs.
We should know soon.
Soon is good.
How's the chelation going? Reverend Moon started it about 20 minutes ago.
You missed lunch tracking down the plasma donors.
Got you a Reuben from the cafeteria.
Thanks.
Lead exposure's a nice diagnosis.
I hope it pays off.
It will.
I appreciate your confidence, but she's not really Oh, no, she could die.
But technically' it would still pay off.
Even if your patient dies, someone will get the lungs.
You really haven't changed.
But I've given up red meat.
What round of chelation is this? Fourth.
Are you checking up on me? Or on House? On this case.
Unique situation.
Oxygenating? Airway resistance down.
Great.
Ls House okay? I have no idea.
Dad, what are you doing here? Got your text.
I brought you some of your mother's gomguk.
What text? The one asking me to bring you some dinner.
I went by Neurology.
The secretary said you were on leave.
I'm consulting on this case.
Unique situation.
Looks very complicated.
You can help with that? Lungs are crashing.
I have to go.
Bye.
Increasing to 100% FIO2.
Saline flow is down to 10 cc.
Blockage? Clot in the line? Chelation is making it worse, which means we were wrong about lead.
Hold the analysis and help me save this thing.
Saline's flushing forward, but getting no return.
One-way valve.
Vasospasm.
If you're right, calcium channel blocker should relax the artery.
The lungs have no nervous system, will that still work? We'll know soon.
Saline flow's rising.
Vasospasm's relaxing.
Left lung is pinking up.
Good job.
Right middle lobe isn't.
Nothing.
We killed part of the lung.
Page Dr.
Pinto stat to the cath lab.
We're going to the oath lab? Are you thinking that What? Who? One dead lobe means four live ones, means enough to transplant, with a side order of dead tissue that we can test.
Makes sense, unlike you stealing my phone.
You have unlimited texting.
Until your parents know, you'll never see that punch for what it really was, your February 4th.
Sri Lankan Independence Day.
I told you I'm Korean and Filipino.
And I told you I wasn't listening.
By my actions.
Violence isn't an appropriate way to handle conflict.
It was a moment of weakness.
You've barked at me, picked a fight with a painting crew.
Maybe ifs time to recognize it's not a character flaw.
Maybe it's your character.
Pinto.
House.
Embrace your inner bitch.
So, why did chelation make the lungs worse? We got about five minutes till Pinto gets back.
Give me a hand with this.
No.
I tracked down another bag of plasma from the batch they used on the donor, negative for all our other exposures.
Sarcoidosis could be inflamed by the treatment.
I'm a cripple, in need of assistance.
Transplant team ran an ACE, negative.
It's mine.
And it's your job.
My job is to assist you in curing the lungs.
This chair will help me do that.
What if the scrapings from the bridge contained other heavy metals, like beryllium, or asbestos? Chelation for lead wouldn't have made them worse.
But maybe the problem isn't a heavy metal from outside.
It's inside.
But it's not leaving the body like it's supposed to, it's stuck.
Iron.
Donor had hemosiderosis.
His body wasn't disposing of iron, massive amounts choke up the lungs.
Then our chelation would wreak havoc because it picks up too much stuff.
Go stain the dead lung tissue for iron.
I'm sorry, young lady, I simply will not help you steal this chair.
Pinto.
House.
Hi.
She can barely catch her breath.
Lungs ready yet? We had a small setback.
We're testing for iron overload.
I thought it was lead.
This is not an exact process.
Your small airways are collapsing.
You're not getting enough oxygen.
I'd like to try forcing an oxygen-rich slurry into your lungs.
It should open up the airways and buy you some time until the lungs are ready.
Fluid in my lungs? Sounds like drowning.
It is.
Gonna hurt, isn't it? Yes.
A fair amount.
No.
I'm done.
House, the nurses saw you come in.
Enter.
It's a bathroom.
Ah! Explains the hole in this chair.
God, I've missed doors.
And air freshener.
Now go away.
I'm waiting for some test results.
My patient signed a DNR, she's giving up.
Looks like someone else will be getting the lungs.
Making this yet another interaction with you in which I get nothing.
It's not my fault you can't handle your patient.
She said she's done.
I spent half an hour trying to change her mind, but she'd made her decision.
I accepted that.
It's called respect.
What's after respect? You find another angle, you hold her hands, get the sister to beg, stick your fingers in your ears and pretend you can't hear her.
Do whatever it takes.
Oh.
Whatever it takes'? Thanks, House, I hadn't thought of that.
- What are you testing for? - Hemosiderosis.
I'm staining for excess iron.
Promising.
When your dad showed up unexpectedly, House have a hand in that? I'm guessing he does things like that a lot.
His version of a compliment.
I spoke to the head of Neurology in Chicago.
I gave you a good recommendation.
Did you mention what happened? Lawyers say I'm not allowed to.
Works out well for everyone.
Why exactly is that good for you? Excuse me? I'm a talented physician, top 2% of my class.
I'm an asset to this hospital, an asset you're about to lose to Chicago.
You applied for the job, you asked me to call and recommend you Andrews is the one that should leave, he's the supervisor.
He touched me first I can't discuss any of that, not before the hearing.
But if you're having doubts about Chicago, I can call them back.
No.
Thank you.
Dr.
Foreman, would you look at this? Iron? No.
White blood cells.
Classic presentation of an infection.
How the hell did we miss that? Biopsy revealed white blood cell infiltrates.
Infection was right after all.
Fresh fruit in prison is usually chicken.
Why aren't you more alarmed? We're running out of time.
She's dying! Were you able to figure out what was wrong while I was screaming? Infection was the first thing that the transplant team treated for.
Which would've worked if the bacteria had been out in the open.
If they're hiding inside the lung's cells I'm thinking Brucella.
To wipe that out, you need special ops.
An intact immune system.
But that's what white blood cells are.
They're part of the immune defense force, like the infantry.
Those lungs need the Air Force, the Marines, antibodies raining down from above.
Antibiotics and MG.
Did you use metaphors for your old team? Or do you just think I'm particularly stupid? No.
They were stupid, too.
What are you doing here? I'm here for Vanessa.
Now is not the time, Bobby.
She asked me to come.
Right, Doc? Actually, it was my idea.
What? What are you thinking? She doesn't want to see him.
When Vanessa was ready to quit chemo, Bobby's the one who got her to do one more round.
Yeah.
And then he got her drunk.
At least tell me you haven't been drinking today.
I should go.
Yeah.
Hail, hail, the gang's all here.
Hey, beautiful.
Hi.
Case is under control.
It's me time.
Vanessa's gonna do the lung slurry.
You were right to push me.
I needed that.
Thank you.
So we're good? It was good advice.
I just came here to say thank you.
I like you.
I have fun with you.
And if you can honestly say that you don't like me, you don't have fun with me, I can accept that But just do whatever you have to do to get over this.
Punch me in the face, kick me in the nuts.
Either/or.
Both seems excessive.
The thing is' House, I don't like you.
When did the discoloration start? A few minutes after I started the MG.
Means we're wrong about infection.
And by we, you mean you.
You screwed up the lungs.
Wrong about auto-immune, about cancer, heavy metals, genetic issues Increase PEEP.
Already maxed out.
We're close to the point of no return.
The lungs will never be viable for transplant.
L need I need ideas.
IgA nephropathy? It's already ruled out.
Lupus? No.
Maybe we're just out of time.
We're out of time when we're out of time.
When they die or she dies.
Keep them stable as long as you can.
I need to think.
One, two, three! Make a wish, make a wish! The lungs are smoker.
You of all people should know better.
But the kid never smoked.
He played poker.
Who plays poker without cigars? Even if he didn't light up himself.
It was a rainy night.
The windows were closed.
All parents think their kids are special.
These ones were right.
At least his white blood cells were special.
They had an on switch for reacting to smoke, but no off.
If he inhaled small amounts of smoke, he had small problems.
No one even noticed.
Big amounts of smoke is enough to trash a lung.
As soon as he breathed in all that cigar smoke' he was a dead man.
The motorcycle accident was an unnecessary dramatic flourish.
Eosinophilic Pneumonitis.
But the steroids would have treated for that.
I was right.
Not about anything medical, but my metaphors were perfect.
We need to hit it harder.
We need to carpet bomb, blitzkrieg.
We need the nuclear option At some point, you're gonna say we need to radiate, right'? See? The metaphors work.
But that'll destroy the good lung, too.
Better to go with a strong cocktail of immunosuppressants.
Won't be fast enough.
Wilson needs these lungs.
It's working.
He did ii.
I'm not going to Chicago.
If you stay, we'll have to have a hearing.
I know.
Dad.
Do you have a minute? Thoracic cavity clear.
Ready for the donor lungs.
Thank God you called him.
Wonder what happens now.
She can handle it.
House.
Got something for you.
Found your stuff in storage.
This is all you get.
Ortho still has the outer office.
Well, that sucks.
Where are Chase, Taub and Thirteen gonna sit? You're welcome, House.
Dinner later? I'll pick something up.
I heard about a good new vegetarian place.
Screw that.
I want a steak.
I'll meet you at your place at 8:00.