Season 1 X 03: Occam's Razor

Original Airdate: 11/30/2004
Written by: David Shore
Directed by: Bryan Singer
Transcript by: Mari

BEGINNING

[Cut into an older looking building and then into a room with a boy sitting and talking on the telephone without a shirt on.]

Brandon: I didn’t sleep well last night, and I woke up with a scratchy throat. I just don’t feel so good. [Pause] Uh, cough, [clears his throat] Yeah, I’m, I’m, a bit of an upset stomach too, and I think I’m running a fever, I’m just worried I might be contagious. [Coughs] Inventory, tomorrow, yeah I’m sure I’ll be feeling better by then. [Pause] Thanks, Mr. Nobby.

[Turns off the phone and lays back, we can now see that there is a young girl in bed with him.]

Mindy: I cannot believe you just did that.

Brandon: I really do have a cough.

Mindy: Oh, so you weren’t lying, you’d be curled up in bed with a bowl of chicken soup even if you didn’t have a horny girl in your bed?

Brandon: Yes, [laughs] Because I really do, hey, I really do have a cough.

Mindy: You also have a little rash. [giggles]

Brandon: Um, umm, I’m uh not sure that we should be kissing.

Mindy: Oh, that’s ok, because I have almost no interest in kissing you.

Both: [Laugh]

[Cut to a very explicit sex scene. All you really need to know is that it was very rough, and his next-door neighbors are probably hating him right now.]

Mindy: [Panting and giggling] Oh, Brandon. (singsongy) Brandon, I know I’m good but come on. Brandon, Brandon, Brandon… [Brandon is unconscious.]

[Cut to back out of the building, you can still hear the girl calling for Brandon.]

[Cut to Credits]

[Cut to a room at PPTH, you can see Brandon in the bed hooked up to a bunch of stuff, and the Girl is sitting there with him. You can see that his rash has spread and he is looking very uncomfortable.]

House: Why do you want me to treat this guy?

Wilson: Blood pressure’s not responding to IV fluids.

House: No, no I didn’t ask how you plan to con me into treating him, I asked you why YOU want me to treat him.

Wilson: He’s sick, I care, I’m pathetic.

House: There are about a billion sick people on the planet, why this one?

Wilson: Because this one’s is in our emergency room.

House: Ah, so it’s a proximity issue. If somebody was sick in the third floor stairwell that’s who we would be talking about.

Wilson: Yes, I checked the stairwell, it’s clear.

House: Ok then, emergency room guy it is.

Wilson: Wait, how was that so easy?

House: You know why.

Wilson: Blood pressure’s not responding to IV fluids?

House: Yeah, that’s just weird.

[House enters elevator. Cut to House’s office with Ducklings.]

House: CBC was unremarkable, abdominal CT scan didn’t show anything. So, people, differential diagnosis. What’s wrong with her?

Cameron: Him.

House: Him, her, does it matter? Does anyone think it is a testicular problem? No, so Chase…

Chase: Absidia infection?

Foreman: No, you wouldn’t get the rash or cough. What about arthritis? Accompanying vasculitis causes nerve damage–

Cameron: No, it wouldn’t cause the blood pressure problems. Allergy?

Chase: The kid’s got abdominal pain. Maybe carcinoid?

Foreman: Nah, but then you wouldn’t get the – [House slams a giant book in front of Foreman.]

House: Foreman, if you’re going to list all the things it’s not, it might be quicker to do it alphabetically. Let’s see. Absidia? Excellent.< Doesn’t account for any of the symptoms.<

Cameron: No condition accounts for all these symptoms.

House: Well, good! Because I thought maybe he was sick, but apparently he’s not. Who wants to do up the discharge papers? [pause] Okay, unless we control the blood pressure, he’s going to start circling the drain before we can figure out what’s wrong with him. Treat him for sepsis, broad-spectrum antibiotics and I want a cort-stim test and an echocardiogram.<

[Cut to the echocardiogram. Brandon is coughing.]

Chase: You all right?

Brandon: Yeah.

Foreman: Cort-stim tests will tell us if your pituitary and adrenal glands are working properly.

Mindy: His glands?< What does that mean?

Chase: We have a few theories we’re working on.

Mindy: You mean you don’t know.

Brandon: Mindy…

Mindy: I’m just saying if they knew they wouldn’t be testing you, they’d be treating you.

Foreman: Yeah, well, that’s the way it works. First you find out what it is, then we get you better.

[Cut to House entering the clinic.]

Cuddy: You’re half an hour late.

House: Busy case load.

Cuddy: One case is not a “load”.

House: So, how are we doing on cotton swabs today? If there’s an acute shortage I could run home –

Cuddy: [looks at his leg] No, you couldn’t.

House: Nice. [He walks over to the waiting room full of patients.] Hello, sick people and their loved ones! [Cuddy looks at him incredulously.] In the interest of saving time and avoiding a lot of boring chit-chat later, I’m Dr. Gregory House. You can call me Gregg. I’m one of three doctors staffing this clinic this morning.

Cuddy: Short, sweet.< Grab a file.

House: This ray of sunshine is Dr. Lisa Cuddy. Dr. Cuddy runs this whole hospital so, unfortunately, she’s much too busy to deal with you. I am a bored [looks at Cuddy] certified diagnostician with a double specialty of infectious disease and nephrology. I’m also the only doctor currently employed at this clinic who is here against his will.< That is true, isn’t it? [Cuddy just looks at him.] But not to worry, because for most of you this job could be done by a monkey with a bottle of Motrin.< Speaking of which, if you’re particularly annoying, you may see me reach for this. This is Vicodin. It’s mine. You can’t have any. And no, I do not have a pain management problem, I have a pain problem. But who knows? Maybe I’m wrong. Maybe I’m too stoned to tell.< So, who wants me?< [None of the clinic patients seem too eager.] And who would rather wait for one of the other two doctors? [Everyone raises their hands.] Okay, well, I’ll be in Exam Room 1 if you change your mind.

Cuddy: Jodi Matthews? [Jodi stands.] Please accompany Dr. House to Exam Room 1.

[Cut to Chase walking in the hallway. Mindy runs up to him.]

Mindy: Dr. Chase!

Chase: I’m not sure scaring your boyfriend is the best medicine for him right now.

Mindy: I know, I get… stupid when I’m scared.

Chase: Don’t go rock climbing.

Mindy: Look, I was wondering…. Before this happened, we were having sex.

Chase: What, you, you’re wondering if whatever he has you might have gotten it? It’s unlikely, we ran a complete STD panel, so –

Mindy: No, I was wondering if maybe I did this to him. I was kind of rough.

[Cut to House in the exam room with Jodi.]

Jodi: It was yellow.

House: It was?

Jodi: It’s not any more.

House: Hmmm, that’s a shame.

Jodi: I thought that might be a problem, so I brought you this. [She hands him a paint color sample card.]

House: Your mucus was pale goldenrod.

Jodi: Last week, yes. Should I be worried?

House: Oh, yes. Very.

Jodi: Really? I thought I was okay now.

House: And yet, here you are. What happened? Paramedics took a week to respond to your 911 call?

Jodi: You’re not a very nice doctor, are you?

House: And you are very bad at whatever it is you do.

Jodi: You don’t even know me!

House: I know you’re going to get fired. That’s why you got the new glasses, that’s why your teeth are sparkly white. You’re getting the most of your health insurance while you still can.

Jodi: I might be quitting.

House: If you were quitting you would have known that last week when your snot was still pale goldenrod; you’re getting fired.

Jodi: I just don’t like being told what to do.

House: I’ll get you in for a full body scan later this week.

Jodi: Thanks.

[Cut to Chase, Cameron and Foreman in the lab.]

Foreman: It’s got to be viral. We should start running gels and tiles.

Chase: We should test the girlfriend’s theory. She thinks she rode him to death.

Foreman: [laughs] What did you tell her?

Chase: Well, I told her 22-year old men don’t die of sex.

Cameron: What’d you ask her?

Chase: What do you mean?

Cameron: I mean, I hope you got some specifics on exactly what was going on. It’s a girl who thinks it could kill you… it’s worth knowing about. [pause]

Chase: Have you ever taken a life? [Cameron gives him a dirty look. Foreman gets the lab results from the printer.]

Foreman: We should stop the antibiotics.

Cameron: It’s too soon to say they’re not having an effect.

Foreman: They’re having an effect. His BP’s falling fast. [Cut to a shot of Brandon coughing.] There’s fluid filling his lungs. His creatine’s rising. [CG shot of the IV meds hitting Brandon’s bloodstream.] His kidneys are shutting down. Our treatment isn’t making him better, it’s killing him.

[Cut to House’s office.< Cameron is adding “kidney failure” to the list of symptoms on the white board.]

House: So, we had six symptoms that didn’t add up to anything, now we have seven.< Who’s excited?

Foreman: I don’t think it complicates things. The kidney failure was caused by the antibiotics.

House: Maybe.

Foreman: Typically, low blood pressure and abdominal pain means an infection. An abdominal infection causes sepsis, low blood pressure…

Chase: Except we checked for abdominal infections.

Foreman: I know, but what if it’s the other way around. What if the low blood pressure is causing the abdominal pain?

Cameron: Viral heart infection. The intestines aren’t getting enough blood, and the result is belly pain.

Foreman: I know it’s not the standard presentation.

Chase: It’s a 10 million to one shot.

Foreman: I thought that’s what we dealt with, here. It explains the cardiomyopathy, pain, the low BP, the fever.

House: You read the book.< Impressive. It’s a ludicrously long shot that explains every one of those symptoms, except for the cough and the rash. Should we just erase those?

Foreman: Well, anything can cause a rash.

House: Okay. [He grabs a colored marker.] Cardiac infection. [He circles all of the applicable symptoms, puts down the marker, and then picks up a different marker.] Cameron, you thought… allergy? [Circle, new marker, repeat.] Chase, what was it you thought, carcinoid?< And then there’s hypothyroidism, could be parasites. Finally, sinus infection.

Foreman: If you’re going to list all of the things it can’t be, you’re gonna need more colors.

House: Cameron was right.< No condition explains all these symptoms. But orange and green covers everything.

Chase: Orange and green?< Two conditions, contracted simultaneously?

Foreman: Occam’s Razor.< The simplest explanation is always the best.

House: And you think one is simpler than two.

Cameron: Pretty sure it is, yeah.

House: Baby shows up.< Chase tells you that two people exchanged fluids to create this being. I tell you that one stork dropped the little tyke off in a diaper. You going to go with the two or the one?

Foreman: I think your argument is specious.

House: I think your tie is ugly. Why is one simpler than two? It’s lower, lonelier… is it simpler? Each one of these conditions is about a thousand to one shot. That means that any two of them happening at the same time is a million to one shot. Chase says that cardiac infection is a 10 million to one shot, which makes my idea 10 times better than yours. Get a calculator, run the numbers.

Chase: We’ll run the tests.

House: Tests take time. Treatment’s quicker. Start the kid on Unacin for the sinus infection and… what was orange?

Cameron: Hypothyroidism.

[Cut to Brandon’s room.]

Brandon: My uncle has hypothyroidism.

Cameron: Not like this. Intravenous levothyroxine is an artificial thyroid medication that should take care of it. Also, the nurses are going to start you on Unacin, it’s a more targeted antibiotic.

Mindy: For the sinus infection?

Cameron: Yes.

Mindy: And the other stuff is for… something else entirely?

Cameron: Bad luck, huh? Don’t worry, he should be back to ditching work in no time. [The door opens, Brandon’s parents come in {referenced as Mr. and Ms. Merrell)]

Mrs. Merrell: Brandon?

Brandon: Hey. [coughing]

Mr. Merrell: We’re his parents. How’s he doing?

Cameron: Um, Brandon is –

Brandon: Um, Mom, Dad, this is Mindy. I was going to bring her home for Christmas, so…. We’re engaged. [Cameron raises her eyebrows. Brandon’s parents smile.]

[Cut to Cameron leaving the room, Chase and Foreman catch up to her.]

Chase: Tell the family House’s theory?

Foreman: Two odd conditions striking completely coincidentally at the exact same time?

Cameron: I didn’t phrase it quite that way.

Chase: They agree to treatment?

Foreman: Of course they did, we’re doctors. They believe whatever we tell them. [pause] So, is that our job? House’s puppets? He comes up with an insane idea, we get to pretend it’s not?

Cameron: His insane ideas are usually right. We’ve been here long enough to–

Foreman: -been here long enough to have Stockholm Syndrome. [Chase and Cameron laugh.]

Chase: What? Because we don’t hate him? He thinks outside the box, is that so evil?

Foreman: He has no idea where the box is! If you guys think he’s right, go home. Relax. Just wait for the kid to get all better. I’m going to the lab to test for viral infections. [He walks off; Chase and Cameron follow.]

[Cut to the lab, where the ducklings are working on gels.]

Foreman: Negative for Coxsackie-B virus.

Chase: Seven down, about 5000 to go. You really think we’re going to come up with your mystery virus by running gels until we guess it right? [We see that Cameron is in a separate part of the lab from Foreman and Chase.]

Foreman: No, I think we’re going to get it by standing around watching other people work.

Chase: I’m waiting for the Epstein Barr virus. [looks at Cameron] She’s weird, isn’t she?

Foreman: Bad idea.

Chase: What?

Foreman: Bad idea. You work with her.

Chase: What did I say? Is “weird” some new ghetto euphemism for sexy, like “bad” is good and “phat” is good? Then what the hell does “good” mean?

Foreman: “Ghetto euphemism”? [Chase laughs.] You don’t think she’s hot?

Chase: No.

Foreman: Wow, then you’re brilliant. And I am using “brilliant” as an euphemism.

Chase: Obviously, the girl is hot. You, you’re not talking about her aesthetics, you’re talking about if I want to jump her. I don’t.

Foreman: Brilliant. [long pause, a test beeps] Your Epstein Barr is ready.

[Cut to the clinic, where House is very involved in his Gameboy.]

Clinic patient: What are you doing?

House: Level 4.

Patient: No, I mean –

House: I know what you meant. We’re waiting.

Patient: My throat hurts.

House: So you said.

Patient: How long are we waiting?

House: Two minutes less then when you asked me two minutes ago. [Cuddy walks in.]

Patient: Hi.

Cuddy: Hi. I’m Dr. Cuddy. Nice to meet you.

House: Dr. Cuddy, thanks for the consult. [He closes the Gameboy.] His throat seems to have some condition.

Cuddy: Say “Ah”.

Patient: Ah.

Cuddy: He has a sore throat.

House: Of course!< Yes, why didn’t I… I mean, because he said that… it hurt, and I, I should have deduced that meant it was sore…

Cuddy: I was in a board meeting.

House: Patients come first, right?

Cuddy: Wouldn’t want to prescribe a lozenge if there was any doubt about it’s efficacy, huh?

House: You once asked why I think I’m always right, and I realized that you’re right… at least, I think you’re right. I don’t really know now, do I? [Cuddy smiles.]

Patient: Hey! I’m here.

Cuddy: Go home. Drink some hot tea. [She leaves.]

House: Excellent counsel.

[Cut to the lab. Now Cameron and Foreman are working together, with Chase off in the separate room.]

Cameron: Negative on parvovirus B19.

Foreman: I’m impressed.

Cameron: Thank you, I was born to run gels.

Foreman: I meant about Chase.

Cameron: What about Chase?

Foreman: Well, the man has no physical interest in you. He has a completely professional relationship with you, he respects you as a colleague and a doctor, and yet he can’t look at you without thinking sex.

Cameron: Because I asked what kind of sex could kill you?

Foreman: You now have total control over your relationship with him.

Cameron: So, a woman can’t express her interest in sex without it being some professional powerplay?

House: No. [House walked in to the lab, unbeknownst to the other doctors.] If you look the way you do, and you say what you said, you have to be aware of the effect that it’ll have on men.

Cameron: Men should grown up.

House: Yeah. And dogs should stop licking themselves, it’s not gonna happen. [Chase comes in.]

Chase: What’s going on? [Cameron abruptly stops laughing.]

Cameron: Yeah, what are you doing here?

House: Looking for you guys.

Foreman: Why didn’t you page us?

House: ‘Cause I knew you’d be here.

Chase: Who told him?

House: No one. I assume you’re trying to prove my crazy two-illness theory wrong, so, obviously, you’re going to be in the lab. You spin the urine? [He pops a Vicodin.]

Foreman: Not yet.

House: Talk to me when you have.

[Cut to House’s office, later. House and Wilson are sitting there; Foreman enters.]

House: What did you find out?

Foreman: The kidney failure. It’s acute interstitial nephritis.<

House: I wonder if that’s signifigant.

Foreman: It means the antibiotics didn’t cause the kidney failure. How did you know?

House: Well, if you guys hadn’t been so busy trying to prove me wrong, you might have checked in on the poor kid.

Foreman: You visited a patient?

House: I was sitting by his bed all morning, just so he’d know someone was there for him.

Wilson: I looked in on him. He’s much better.

House: Ergo, the treatment’s working. Ergo, me right, you wrong.

Foreman: Hey, I’m glad for the kid. [He leaves.]

Wilson: That smugness of yours really is an attractive quality.

House: Thank you. It was either that or get my hair highlighted. Smugness is easier to maintain.

Wilson: I get that you’re not a big believer in the ‘catching flies with honey’ approach, but do you honestly think you’ll collect a jarful by cleverly taunting them?

House: Flies, no. Doctors, sure. If I’d said to Foreman, “Nice try, it was a great guess, but not this time,” what do you think he’d be doing right now?

Wilson: I think he’d be going home not feeling like a piece of crap.

House: Exactly.

Wilson: You want him to feel like a piece of crap?

House: No, I don’t want him going home.

[Cut to Foreman entering Brandon’s room.]

Brandon: Dr. Foreman. [coughs]

Foreman: Still have the cough.

Brandon: I’m feeling a lot better, though.

Mrs. Merrell: His fever’s gone, and his rash is going away.

Foreman: I see.

Mindy: Is everything okay?

Foreman: Just ordering some tests. Absolutely nothing to worry about.

[Cut to House in the clinic exam room. He’s again playing on the Gameboy.]

Patient: How much longer?

House: 9:30, I figure she was on the 8th hole when I paged her… [he grimaces as his guy dies, and hands her the Gameboy] Probably got another half hour. [She starts to play as Foreman opens the door.]

Foreman: I ran a TSH, T3 and T4. Patient’s negative for hypothyroidism. [Patient looks up.] Not talking about you. [She goes back to the Gameboy.]

House: Well the fact that he’s getting better would indicate the unreliability of the tests.

Foreman: If I’m right and it’s a viral infection, one of two things always happens: patient dies or the patient’s immune system fights off the invader. [nods toward patient] What’s with her?

House: Her leg hurts after running six miles. Who knows, it could be anything!

Foreman: He’s getting better. That doesn’t prove you’re right, it just proves he’s getting better. [House smiles.] It, it’s not two illnesses! It can’t be two illnesses!

House: I am so glad you work here.

Foreman: If I’m right, the antibiotics you prescribed could block his kidneys and liver, impeding his ability to fight off the virus. Could kill him.

House: Well, that certainly would be a concern. Fifty bucks? [Patient looks up.] Don’t look away, the space monkeys will be all over you.

Foreman: You wanna bet on the patient’s health?

House: You think that’s bad luck? Do you think that God will smite him because of our insensitivity? Well, if God does, you make a quick fifty. [Patient kills the little guy on the Gameboy.] Go check his white blood count. If he’s fighting off a virus like you think it’ll be way up. [He starts to play on the Gameboy again. Foreman leaves, and Wilson enters.]

Wilson: Hey, Cuddy said you needed a consult, what’s up? I’m busy.

[Cut to Cameron and Chase in House’s office. Chase is pouring coffee, and, after looking at Cameron, spills it.]

Chase: Ah!

Cameron: I was just being glib.

Chase: You haven’t said anything.

Cameron: No, before when I was talking about Brandon’s girlfriend thinking sex could kill you. I was just making a joke because I was uncomfortable.

Chase: Oh, I don’t even remember what you said.

Cameron: I’m uncomfortable about sex. [Chase turns quickly.]

Chase: Well, we don’t have to talk about this…

Cameron: Sex… could kill you. Do you know what the human body goes through when you have sex? Pupils dilate, arteries constrict, core temperature rises, heart races, blood pressure skyrockets [Chase is starting to look uncomfortable], respiration becomes rapid and shallow, the brain fires bursts of electrical impulses from nowhere to nowhere and secretions spit out of every gland [Chase starts to look for an escape route], and the muscles tense and spasm like you’re lifting three times your body weight. It’s violent, it’s ugly, and it’s messy, and if God hadn’t made it unbelievably fun… the human race would have died out eons ago. [small pause] Men are lucky they can only have one orgasm. You know that women can have an hour-long orgasm? [Chase is very wide-eyed; Foreman walks in.] Hey, Foreman. What’s up?

Chase: Hey, Foreman!

Foreman: Hey. [House walks in.]

House: White cell count isn’t up, is it?

Foreman: No. We were both wrong.< White cell count is down, way down, and dropping. His immune system is shot. We need to get him into a clean room.

[Cut to Chase and Brandon, in prep for the clean room.]

Chase: Can you walk, Brandon?

Brandon: Yeah, a little.

Chase: All right, okay. ‘Cause we’ll need to leave the chair outside. [to the nurse helping him] Thank you. Where’s April? April!< [April comes in.] Can you take the chair, please? [to Brandon] I’ll need to take your mask and your robe, too. You might want to block your ears for this, it’s quite loud. [They’re blasted with air. Next we see Cameron, Foreman, the Merrells and Mindy watching Chase and Brandon in the clean room.)

Foreman: Something’s made his immune system compromised.

Cameron: His white blood cell count is down, which means his body can’t fight off infections.

Foreman: If he gets sick, he’ll die.

Mrs. Merrell: Sick. How sick?

Foreman: If he gets a cold, he’ll die.

[Cut to Brandon, coughing. Foreman is prepping him for a marrow sample.]

Foreman: Okay. I’m going to push the needle into your hipbone, and take some of the marrow. [He inserts a needle.]

Brandon: That’s not so bad.

Foreman: Hah, that was just the anesthetic. The core biopsy needle, it’s a little bit bigger. Okay man, take a deep breath, this is, this is gonna hurt. A lot. [Brandon seizes the bed and grimaces in pain.] Marrow makes the blood cells. You take a peek of it under a microscope, and maybe we find a viral infection. Maybe we find some fibrosis. Something to explain why your blood count is so low. [He fills the syringe with marrow.] There we go. One step closer to an answer.

Brandon: What if you don’t find one? I can’t stay here forever.

[Cut to Cuddy’s office.]

House: The patient could have died.

Cuddy: The one with the pulled muscle.

House: Well, those symptoms are consistant with a dozen other conditions. I, you know, I, I’m entitled to a consult!

Cuddy: You are not getting out of clinic duty.

House: Oh, come on. You’ve got a hundred other idiot doctors in this building who go warm and fuzzy everything they pull a toy car out of a nose, you don’t need me here.

Cuddy: No, I don’t, but working with people actually makes you a better doctor.

House: When did I sign up for that course?

Cuddy: When did I give you the impression that I care? [pause]

House: Working in this clinic obviously instills a deep sense of compassion. [He starts to walk out.] I’ve got your home number, right? In case anything comes up at 3 o’clock in the morning.

Cuddy: It’s not going to work. You know why?< Because this is fun. You think of something to make me miserable, I think of something to make you miserable: it’s a game!< And I’m going to win, because I got a head start. You are already miserable. [Cuddy leaves her office, and runs into Wilson.]

Wilson: Uh…

Cuddy: Is this important?

Wilson: Uh, no.

Cuddy: No. [She leaves, as House exits her office.]

Wilson: What’s with you and her?

House: Don’t.

Wilson: Do you have a thing for her? The only people who can get to you –

House: No! There is not a thin line between love and hate. There is, in fact, a Great Wall of China with armed sentries posted every 20 feet between love and hate. [to the pharmacist] 36 Vicodin.

Pharmacist: Who’s the patient?

House: I am.

Pharmacist: You can’t…

House: Dr. Wilson is the prescribing physician.

Wilson: Yeah. [to House]< You will lie, cheat and steal to get what you want, but you’re incapable of kissing a little ass?

House: Well, we all have our limitations. [He grabs a bottle from the counter and turns to leave.]

Wilson: House!< Wrong bottle. [He gives House the right bottle.] Do me a favor. Take one of these, wait five minutes for it to kick in, and find Cuddy, and kiss her ass. [pause]

House: What was the kid’s first symptom? [small pause] You did the history; of his 800 symptoms, which one hit him first?

Wilson: Ah, the cough.

[Cut to House thinking in his office, staring at the white board. He starts looking through medical texts and searching online; Chase watches him through the glass wall.]

[Cut to Brandon, who is still coughing.]

[Cut to the ducklings, sitting in their office. House walks in.]

House: Gout. [He walks back into his office; they follow.]

Chase: Um, are we talking about Brandon?

Foreman: Gout? Uric acid crystals in the joints? The symptoms are pain, swelling, redness, stiffness… not one of which do I see on that board.

House: Because he doesn’t have gout. Every day, cells die. [CGI of… cells!] We survive because the remaining cells divide and replace the losses. The colchicine, a gout medicine, blocks mitosis and stops cell division, which will result in abdominal pain, rash, nausea, fever, kidney failure, low blood pressure, and will also mess with the bone marrow. [He crosses these all off the board.]

Chase: But he doesn’t have gout. Why would he have gout medication?

House: Because you guys were right. He didn’t have two medications at the exact same time. First, he got a cough. Now, because he’s an idiot, he went to a doctor. In order to feel justified charging $200, the doctor felt he should actually do something. Oops. He wrote a prescription. 7000 people die each year from pharmacy screw-ups. Not nearly as many as die from doctor screw-ups, but still, not something they use in their promotional material. The pharmacist gave him gout medicine instead of cough medicine. And the only thing it wouldn’t do: it would do absolutely to relieve his cough. Occam’s Razor. The simplest explanation is almost always somebody screwed up.

Cameron: But once he checked into this hospital he was completely in our control. Our food, our pills, our everything. So even if you’re right, no gout medication.< He’d either continue to deteriorate or he would have gotten better. But he got better, and then he got worse. It doesn’t fit. It doesn’t make sense.

House: Okay. Two people screwed up.< Not as simple as one, but…

[Cut to the Merrells and Mindy sitting in a waiting room. House and Co. come walking up to them.]

Mindy: He’s resting; he –

House: I’m Dr. House.< I’m your son’s physician.<

Mrs. Merrell: Oh, you’re the one we haven’t met yet.

Mr. Merrell: You’re the one he hasn’t met. How can you treat someone without meeting them?

House: It’s easy if you don’t give a crap about them. That’s a good thing. If emotions made you act rationally, then they wouldn’t be called emotions, would they? That’s why we have this nice division of labor: you hold his hand, I get him better. If I start tucking him in at night, well, that’s not fair to you guys, and if you start prescribing medicine, that’s not fair to me. So what I want to know is: who stepped on my side of the med? Who cared enough to get stupid enough to give him his cough medicine?

Mindy: When we checked in Dr. Foreman said –

House: Tuesday, he’s getting better. Wednesday, he’s getting sick again. Somebody gave him his cough medicine Wednesday. [pause] Come on, nobody’s gonna be mad. I just want to know who tried to kill the kid.

Foreman: Dr. House, maybe we should –

Mrs. Merrell: His throat was sore.

House: Page Dr. Occam. He’s gonna want to hear about this.

Mrs. Merrell: Sorry! He was coughing, and I just wanted to help him –

House: I wish you would dare.< Where are the pills?

Mrs. Merrell: He took the last of them before he was switched into that room.

Cameron: They’re all gone?

Mrs. Merrell: It was just cough medicine!

House: No, it wasn’t. Where’s the bottle?

[Cut to a pharmacy. Chase, Mindy and Mrs. Merrell go to talk to the pharmacist.]

Chase: We need to know exactly what you put in this bottle. We think it was colchicine, a gout medication.

Pharmacist: If the prescription said cough medicine, that’s what I dispensed.

Chase: The family is prepared to waive liability, all right? We just need to know what it was, what dosage it was –

Pharmacist: It was cough medicine.

Chase: [gives him the bottle] Refill it.

Mrs. Merrell: He’s going to be okay.

Mindy: You don’t know that.

Mrs. Merrell: Does Brandon like that quality in you? You’re a little negative.

Mindy: Things don’t always work out for the best.

Mrs. Merrell: It doesn’t hurt to hope they do.

Mindy: No. Not unless it makes you figure you can do whatever you want, like give people cough medicine. [Chase and the pharmacist come out from the back.]

Chase: This is cough medication. This is what Brandon was supposed to get. [He shakes out three onto his hand.] They’re small, round and yellow. Can you tell this man what the pills in your son’s medicine bottle actually looked like?

Mrs. Merrell: They were small, round and yellow, exactly like this.

Mindy: Those were the pills that Brandon was taking.

Pharmacist: Hey, I’m just a pharmacist, but I know what cough medicine looks like, Doctor.

[Cut to House’s office.]

House: It was so perfect. It was beautiful.

Wilson: Beauty often seduces us on the road to truth.

House: And triteness kicks us in the nuts.

Wilson: So true.

House: This doesn’t bother you?

Wilson: That you were wrong?< I try to work through the pain –

House: I was not wrong. Everything I said was true. It fit. It was elegant.

Wilson: So… reality was wrong.

House: Reality is almost always wrong. [takes some Vicodin] The cough medicine did something. Aggravated the condition. It’s all over the place, must be in his blood.

Wilson: What if it is his blood?

House: Lymphoma?

Wilson: Unless you’ve got something better.

House: Well, we foolishly ruled out lymphoma because his CT scan showed no adenophathy, CBC showed a normal diffen smear, bone marrow showed no –

Wilson: Screw the tests. Do an exploratory laparotomy and find out what’s in there.

House: He has no blood pressure, no immune system and no kidneys. Surgery will kill him.

Wilson: Yeah, you’re right.< Let’s stick with the wrong pill theory. [pause]

House: I’ll schedule him for surgery.

[Cut to Brandon’s clean room.< Mindy and the Merrells are looking on as the three doctors are working on Brandon.]

Foreman: Okay, Brandon, we’re gonna run this tube through your heart and into the pulmonary arteries in your lung.

Cameron: Sensors will give us information we need for the exploratory surgery later this afternoon.

Brandon: My fingers are numb.

Foreman: Try not to move. We’re in the right atrium, trying to catch the flow through the tricuspid valve.

Chase: I think the catheter’s curling in the atrium.

Foreman: Got it. We’re in the RV in now. [A monitor beeps.]

Chase: Ectopy. You must have irritated the heart wall.

Foreman: It’ll calm down.

Chase: He can’t tolerate any cardiac arrhythmia. Pull back.

Foreman: He needs this surgery. [Another monitor starts to beep.]

Cameron: Pressure’s dropped.

Chase: You still with us, Brandon?

Cameron: Get the curtains! [Chase closes them. They prepare the defibrillator.]

Chase: Charging. Clear! [Shock.] Sign of rhythm.

Cameron: I got a pulse.

Foreman: Yeah, but no surgery today.

[Cut back to the clinic. House enters to find a boy standing in the room.]

House: How you doing?

Patient: Okay.

House: Great. I’m doing good, too. I get to knock off an hour early today. Know why? ‘Cause I kissed my boss’ ass, you ever do that? I think she just said yes because she wants to reinforce that behavior. Wants me to kiss a lot of other people’s ass, like she wants me to kiss yours. [Boy makes an odd face.] What would you want, a doctor who holds your hand while you die, or a doctor who ignores you while you get better? I guess it would particularly suck to have a doctor who ignores you while you die.

Patient: I should go.

House: You think it’s going to come out on its own? Are we talking bigger than a breadbasket? ‘Cause actually, it will come out on its own, which for small stuff is no problem. Gets wrapped up in a nice soft package and plop! Big stuff, you’re going to rip something, which speaking medically, is when the fun stops.

Patient: How did you –

House: You’ve been here half an hour and haven’t sat down, that tells me its location.< You haven’t told me what it is, that tells me it’s humiliating. You have a little birdie carved on your arm, that tells me you have a high tolerance for humiliation, so I figure it’s not hemorrhoids. [pause] I’ve been a doctor 20 years, you’re not going to surprise me.

Patient: It’s an MP3 player.

House: [has to digest this for a moment] Is it… is it because of the size, or the shape, or the pounding bass line?

Patient: What are we going to do?

House: [looks at his watch] I’m gonna wait.

Patient: For what?

[Cut to House leaving the exam room.]

House: Okay, it’s 3:00, I’m off. Would you tell Dr. Cuddy there’s a patient in Exam Room 2 that needs her attention? And the RIAA wants her to check for illegal downloads. [chuckles at his own joke; Cameron runs up.]

Cameron: Brandon’s not ready for surgery.

House: Okay, well, let’s leave it a couple of weeks. He should be feeling better by then. Oh wait, which way does time go?

Cameron: He crashed during prep. He’s also experiencing pain in his fingers. I think some bug may have gotten in the clean room. I think we should double his dosage of GCSF to temporarily boost his blood cell count.

House: Pain in his fingers… right. [pops a Vicodin]

[Cut to the hallway outside the clean room.]

House: [to Mrs. Merrell] Hi again. [He enters the prep area.]

Mrs. Merrell: He can’t go in –

Mr. Merrell: Where’s he going? [House walks in without all of the prep robes, air, etc.]

House: Hey! How y’all doing?< Interesting fact: every seven years it’s a whole new you. Inspiring metaphor, huh?

Chase: Dr. House, this is a clean room.

House: Yeah, I read the sign. But cells of different organs reproduce at different rates. [He touches Brandon’s leg, Brandon flinches and makes noises of protest.] So, a new kidney every three years, a new stomach lining every week…. This is why colchicine poisoning causes all of these symptoms but not all at once.

Mrs. Merrell: But we went to the pharmacy. We saw the pills!

House: Colchicine does its damage in a very specific order. First of all, there’s a pain in the abdomen, the rash, the fever… isn’t that what you got first? Then, the kidneys go, which is exactly what happened to….

Cameron: Brandon.

House: Right. Then it screws up your bone marrow, and then – neuropathy. Painful tingling in the fingers and toes. And what do you suppose happens after that? [He rips out some of Brandon’s hair. His mother doesn’t look too thrilled.] Hair loss. The bad new is: your special boy is doing drugs.

Mrs. Merrell: No, he’s not!

House: Ecstasy?

Mrs. Merrell: No!

Brandon: Twice, with Dan and Mike.

House: D’you know what they cut that stuff with? Apparently colchicine, unless you ingested the colchicine through your contact lens solution, or skin cream, or some other drug you’re lying about. I don’t know how it happened, I don’t care how it happened, it happened. Start….

Cameron: Brandon.

House: Lovely name. Start Brandon on fab fragments, and give him some Tylenol for the hair I pulled out. And get some air in here! [He leaves the room and walks off with Wilson.] Make a note: I should never doubt myself.

Wilson: I think you’ll remember. You know, it wouldn’t hurt you to be wrong now and then.

House: What, you don’t care about these people?

[Cut to the clean room, where Foreman and co. are inserting an IV.]

Foreman: The colchicine interferes with the ability of the heart muscle to contract pumping blood, lowering your blood pressure. [CGI of his heart.] The antibodies we’re giving you should neutralize the colchicine, allowing your heart to beat at its normal rate.

Brandon: When will you know?

Cameron: We know now. [Foreman gives the people outside a thumbs-up. Mrs. Merrell hugs her husband, and then hugs Mindy.]

[Cut to House pawing through the hospital pharmacy.]

Wilson: Big weekend?

House: It’s not for me, I’m fully stocked.

Wilson: Cuddy got you doing inventory?

House: Nope. Trying to solve that kid’s case.

Wilson: The gout medicine OD?

House: Yeah.

Wilson: The fact that I know that it’s a gout medicine OD would seem to indicate that the case is already solved.

House: Well, you’d be wrong.

Wilson: What about the fact that the kid is now, I believe the technical term is, not sick?

House: You know how many forms of colchicine there are on the market?

Wilson: Stop it.

House: Neither do I, but it’s a lot. Pills, powders, liquids, IV fluids…. Somewhere at a party, in his coffee, up his nose, in his ear, this kid had some.

Wilson: So, you’re not happy with your Ecstasy theory?

House: He said he used it twice.

Wilson: People lie.

House: Yeah, but if you’re gonna lie, it’s –

Wilson: You know what, I’m not interested.

House: Not curious?

Wilson: No, because I’m well-adjusted. [He walks off.]

House: Right.

[Cut to Cameron and Chase checking up on Brandon.]

Cameron: Temperature’s normal.

Brandon: I want Cousin Sharon there.

Mrs. Merrell: If we invite Sharon, we have to invite all the cousins.

Mindy: So what? My side of the family doesn’t need anything. [Brandon starts coughing.]

Brandon: Don’t suppose I could have some of those cough pills, huh? They’re okay, right?

Cameron: Yes, you’re doing great.

Chase: You should invite Dr. House.

Brandon: Will he come?

Chase: No, but he’ll send a gift.

Cameron: I’ll make sure it’s a good one. [She give Brandon the cough pills.]

Brandon: There’s a letter on the back of these pills.

Cameron: Your old pills didn’t have a letter on them?

Brandon: No. Round and yellow, but no letter. [pause]

Cameron: Well, these will help your cough. [She starts to leave.]

Chase: Hey, you want to go get some –

Cameron: No.

[Cut to House, once again in the hospital pharmacy. He finds the colchicine and compares them to the cough medicine: small, round and yellow, but minus the letter.]

Season 1 X 02 : Paternity

Original Airdate: 11/23/2004
Written by: Lawrence Kaplow
Directed by: Peter O'Fallon

BEGINNING

Crowd: [Cheering and Shouting]

Player 1: On your right, on your right.

Player 2: Back, back, back.

Dan’s Dad: Yeah, Dan!

Crowd: [Continues cheering and shouting]

Player 3: Back, back, back, back

Player 4: Watch the winger!

Crowd: [More cheering and whistling]

[Zoom in on one player, wearing #29 jersey. Sound becomes muffled, and scene becomes blurred and wavy]

[Cut to inside his head where a neuron fires and then cut back to the field. Player #29 (Dan) gets hit hard by another player]

Dan: [grunts with the impact]

Coach: [muffled] You ok? Dan, Dan, talk to me. Dan, Dan, get a doctor!

[Cut to credits which are sooo cool!]

(commercial, blah, I know that we couldn’t have TV without them but…yuck!)

Wilson: Hey!

House: Close the door. Close the door!

Wilson: Is Cuddy down the hall counting to 50?

House: She’s knows I’m in here, the clinic, as she commanded; she just doesn’t know I’m alone.

Wilson: Well, you’ve got a full waiting room, how long do you think you can ignore them?

House: I’m off at 4:00.

Wilson: You’re doing this to avoid 5 minutes of work?

House: I go out there, I get assigned a kid with a runny nose. That’s 30 seconds looking at the nose; 25 minutes talking to a worried mom who won’t leave until she sure it’s not meningitis or a tumor.

Wilson: Yes, concerned parents can be so annoying. Just tell Cuddy you’ve got an urgent case, you had to leave early.

House: That would be lying.

Wilson: And that would be wrong. But luckily, the definition of urgent is fungible.

[He goes to leave]

House: Not the definition of case though.

[Wilson stops and looks back at House in shock]

Wilson: You have no cases. You have NO cases. You’ve got hand picked doctors, specialists, working for you, and they’re sitting on their hands?

House: Cameron is answering my mail.

Wilson: Time well spent I’m sure. Foreman and Chase?

House: Research?

[Cut to the DM offices and you can see Cameron on a computer typing, Foreman is tapping his fingers and Chase has a book of crossword puzzles open.]

Chase: 9 letters, iodine deficiency in children.

Foreman: Cretinism.

Chase: Huh [Fills in the space]

[Cut back to House at the clinic. He leaves the exam room]

House: So, 4:03 PM. Dr. House checks out. Please write that down.

Dan’s Dad: Dr. House. (from now on he’ll just be called Dad)

House: Sorry, done for the day. There’s plenty of docs here to take care of you.

Dad: But we had an appointment.

House: Hah, nice try, but this is a walk in clinic, which means there are no appointments. It means you walk in, sign the chart and a doctor will see you, just not me.

Dad: But your letter says that we would see you.

House: Not a big letter writer.

Dad: Here.

[Cut onto the letter, now in House’s office.}

House: When did my signature get so girly?

Cameron: I can explain.

House: See that “G”, see how it makes a big loop on top? It doesn’t even look like my handwriting. Think I have something? What’s the differential diagnosis for writing “G’s” like a junior high school girl?

Cameron: It’s impossible to get to you through normal channels, they have called… [interrupted]

House: Perseverance does not equal worthiness. Next time you want to get my attention wear something fun. Low-rider jeans are hot.

Cameron: 16 year old male, sudden onset of double vision and night terrors, with no apparent cause. The kid’s been to 2 neurologists…[interrupted]

House: Night terrors, yeah? As in big scary monsters?

Cameron: Yeah.

[House gets up and grabs his cane]

Cameron: Where are you going?

House: To see the family.

Cameron: You’re going to examine a patient?

House: 9 times out of 10 there’s no reason to talk to a patient, but night terrors in a 16 year old is a VERY good reason to talk to this family. Good work.

[He exits. Cut to an exam room with Dr. House examining the patient (Dan)]

House: Margins look fine. No lesions, color is good. How long have you been having night terrors?

Dan: Three weeks.

Dad: He’s afraid to go to bed, he’s exhausted, he can barely function.

[House flicks at both of Dan’s eyes]

Mom: What does that tell you?

House: Nothing, it’s just fun watching him blink. [To Dan] Name as many animals that begin with the letter “B” go.

[Long pause]

Dan: Baby elephant.

House: Baby elephant is actually a good answer; “B” is a bear of a letter.

Dad: What does that tell you?

House: Proves two things, no neurological damage, and your son is never going to be chief fry cook. In teens there are two likely causes of night terrors: post traumatic stress, any recent shootouts at your high school?

Dan: No.

House: Well, then, Dave…

Cameron: Dan

House: …If there’s no trauma the other cause is sexual abuse. So, who’s molesting you? Teacher, extra friendly neighbor? I’d ask if either one of you were involved, but you’d deny it.

Dad: We would never do anything to hurt Dan.

House: I say it here, it comes out there. This lack of response is consistent with abuse.

Dan: There’s no one, ok? I swear. There was trauma; I got hit in the head during a lacrosse game.

House: [To Cameron] Did you know that he got hit in the head?

Cameron: They didn’t mention it, no.

House: Yeah, why bother.

[House leaves, and they all follow]

Dad: No, no, we took him to the ER after the game. He was scanned, they tested him, they said he was fine. No concussion, it’s gotta be something else.

House: You hound me for my opinion and then question my diagnosis. Cool. ER obviously screwed up, kid’s got a concussion.

Dan: I had double vision before I got hit.

House: Well, that changes everything, you need glasses. That’s why you had double vision, which is why you got hit, which is why you have a concussion, which is why you have night terrors. You need to see an ophthalmologist, which I am not.

Cameron: You enjoyed that. I brought a reasonable case to your attention, and you shoved it in my face just to humiliate me.

House: You’re an only child, aren’t you?

Cameron: Why would you say that?

House: Everything is about you. This may seem incredibly controversial, but I think sexual abuse is bad. I just wanted to make sure he wasn’t being diddled by daddy, or mommy, anything else is just a bonus.

[Knocking sound comes from the reception area; House looks over and sees that Dan’s leg is spasming.]

Cameron: I’m not an only child.

House: [attention on Dan] Interesting.

[House goes back out to Dan and his parents]

Cameron: What?

House: Don’t move. Did I bore you in there?

Dan: What? Ah, no, not, not really.

House: Are you tired?

Dan: Sometimes.

Dad: He never sleeps! Of course he’s tired.

House: Right now, at this moment, are you tired?

Dan: No, no.

House: That twitch in your leg. Did you feel that?

Dan: Didn’t hurt.

Dad: His leg twitched. I don’t see what… [interrupted]

House: It’s called a myoclonic jerk, it’s very common when you’re falling asleep. Respiration rate falls and the brain interprets this as the body dying, so it sends a pulse to wake it up.

Dad: So?

House: So, he’s not asleep, he’s awake. [Turns to Cameron] Admit him.

[Cut to House’s office, Cameron is writing on the white board]

House: I recognize that loopy “G”. So, what does the jerk tell us?

Foreman: Nothing good, the brain’s losing control of the body. Can’t order the eyes to focus, regulate sleep patterns or control muscle movements.

House: A movement disorder, or degenerative brain disease. Either way this kid’s gonna be picking up his diploma in diapers and a wheelchair.

Chase: Maybe not that bad, could be an infection.

House: You wish. No fever, no white count. Anyone think this differential diagnosis might be compromised because we don’t have an accurate family history?

Cameron: I took an accurate family history.

House: You didn’t even take an accurate family. His father’s not his father.

Chase: Why would you say that?

House: 30% of all dads out there don’t realize they’re raising someone else’s kid.

Foreman: From what I’ve read false paternity is more like 10%.

House: That’s what our mom’s would like us to believe.

Cameron: Who cares? If he got it from his parents they’d both be dead by now, can we get on with the differential diagnosis? House: $50 bucks says I’m right.

Foreman: I’ll take your money.

House: Hit a nerve? Don’t worry, Foreman. I’m sure the guy who tucked you in at night was your daddy.

Foreman: Make it $100.

Cameron: What about leucoencephalopathy? In a 16 year old.

Chase: It doesn’t necessarily have to be that bad. If we exclude the night terrors it could be something systemic: his liver, kidneys, something outside the brain.

House: Yes, feel free to exclude any symptom if it makes your job easier.

Chase: The night terrors were anecdotal. He could have had a bad dream.

Cameron: No, parents said he was conscious during the event and didn’t remember anything afterwards. That’s a night terror.

Chase: Parents said?

House: That’s a good point. Before we condemn this kid, maybe we should entertain Dr. Chase’s skepticism. I want a detailed polysomnograph. If he’s having night terrors I want to see them.

[Cut to outside hospital night. Cut into an isolation room, Dan is covered in wires, and other medical stuff.]

[Foreman is typing on a computer and monitoring Dan]

[House comes into the room with a tray on wheels. Dan sits up and is obviously scared. House tightens the restraints that are on Dan’s arms]

Dan: I usually don’t move during night terrors.

House: I’m not restraining you for them. EEG revealed abnormalities in your brain caused by nerve damage in your toes.

[House starts to draw a line around the base of Dan’s big toe]

Dan: [Whimpering] What are you doing?

House: Fixing it.

Dan: [Still whimpering] Can I talk to my parents?

House: Oh, they know all about this.

Dan: I’d really like to see them. [Whimpering after pause] Please! I’d really like them here.

House: This is gonna hurt, Dan.

[House takes up a big tool that looks like monster wire cutters and starts to cut off Dan’s big toe]

Dan: [Whimpers and then screams] Oh, God!

[Neat crunching and tearing sounds come from Dan’s feet]

[Cut to the room, and you see that it was just a night terror, and that Dan’s toes are all still there. He is not in restraints, and he’s sleeping. See a monitor with weird wavy lines on it.]

Chase: That’s a night terror.

(Commercials…blah…a stupid one about batteries on my tape. I don’t care about the bloody batteries! I want more House!)

Foreman: We did a CT, MRI, CBC, Chem-7 and chest x-ray. All the tests came back normal. There’s nothing to explain his symptoms.

House: Ok, but let’s pretend there’s something and go from there. Who sees something on this MRI?

Cameron: No lesions, no white matter.

Foreman: No structural abnormalities.

Cameron: No space-occupying tumors.

House: He’s 16, so he should have an absolutely pristine brain. The smallest thing is abnormal.

Chase: Meningeal enhancement. My bet is viral meningitis.

House: Excellent, you see what he did there? He took a small clue that there’s a neurological problem and wasn’t afraid to run with it.

Foreman: There’s no evidence of meningitis on that MRI.

House: No, there’s not, he completely wrong.

Cameron: Then what clue are you talking about?

House: He knew that I saw something on the MRI so he figured there must be something there and took a guess. Clever, but also pathetic.

Chase: So, what did you find?

House: Take a close look at the corpus collosum.

Chase: It looks ok.

House: Are we all looking at the same thing? 200 million interhemispheric nerve fibers, the George Washington Bridge between the left and right side of the brain. It’s subtle.

[Pause while the ducklings look at the MRI]

Chase: There’s some bowing, there. An upward arch.

House: Are you guessing?

Chase: Yes.

House: Too bad, you’re right.

Foreman: He probably just moved, nobody stays perfectly still for their entire MRI.

House: Yeah, he probably got restless and shifted one hemisphere of his brain to a more comfortable position. Something is pushing on it.

Foreman: If there’s bowing it could be a tumor.

House: Do you see a tumor on this MRI?

Foreman: No, but I don’t see any bowing, either.

House: There’s no tumor, just a blockage causing pressure, causing symptoms. Today night terrors, tomorrow he’s bleeding out of his eyes. Get him a radionucleotide cisternogram. I guarantee you’ll see a blockage.

[Cut to Dan’s room day, Foreman is placing an extraordinarily large needle in his back. This seems to be causing Dan a lot of pain, and his Dad is holding him while he grunts and groans]

Dad: Ok…all right easy…[Pause and then mumbles to Dan, I can’t make it out]

Foreman: Now, I’m injecting a material that’s tagged with a radioactive isotope. It’s gonna enter your spine and travel up to your brain. It’ll make you able to think deep thoughts, at about 100 miles per hour.

Dad: [Whispers] Easy.

[Foreman is checking out the Dad and Dan, trying to prove that the guy really is Dan’s dad. He sees that they both have a strange fleck in their irises.]

Foreman: Their eyes aren’t the same color, but that fleck in the eyes… that’s maybe a one in ten chance if they’re not related?

Chase: Nah, House isn’t gonna pay you based on that.

Foreman: [chuckles] Any excuse we can give the folks to justify a DNA test?

Chase: We could tell them he’s got Huntington’s. The whole family should be tested or they’ll all die.

Foreman: [Chuckles again]

[Foreman notices House entering the lab where he and Chase are sitting]

Foreman: Hey, there’s a lot of blockage.

Chase: I’ve scheduled him for surgery. They’re gonna put a shunt into one of the ventricles to give the cerebrospinal fluid an out.

Foreman: No more pressure, everything goes back to normal.

House: He’s lucky to have you as his doctors.

[House walks away. Cut to the clinic and House is in an exam room with a young mother and her baby.]

Young Mother: No formula, just mommy’s healthy natural breast milk.

House: Yummy.

Young Mother: Her whole face just got swollen like this overnight.

House: Mmhmm. No fever, glands normal, missing her vaccination dates.

Young Mother: We’re not vaccinating.

[Baby giggles and coos]

Young Mother: [Takes a toy frog and starts to make frog sounds] Gribbit, gribbit, gribbit. [Giggles]

[Baby smiles and giggles too]

House: Think they don’t work?

Young Mother: I think some multinational pharmaceutical company wants me to think they work. Pad their bottom line.

House: Mmmm. May I? [He takes the frog and starts to do the gribbit noise with the baby]

Young Mother: [Whispered] Sure.

House: Gribbit, gribbit, gribbit. [The baby laughs] All natural no dies. That’s a good business: all-natural children’s toys. Those toy companies, they don’t arbitrarily mark up their frogs. They don’t lie about how much they spend in research and development. The worst a toy company can be accused of is making a really boring frog.

[Young Mother laughs and so does House. The baby giggles again]

House: Gribbit, gribbit, gribbit. You know another really good business? Teeny tiny baby coffins. You can get them in frog green or fire engine red. Really. The antibodies in yummy mummy only protect the kid for 6 months, which is why these companies think they can gouge you. They think that you’ll spend whatever they ask to keep your kid alive. Want to change things? Prove them wrong. A few hundred parents like you decide they’d rather let their kid die then cough up 40 bucks for a vaccination, believe me, prices will drop REALLY fast. Gribbit, gribbit, gribbit, gribbit, gribbit.

Young Mother: Tell me what she has.

House: A cold.

[Cut to House leaving the clinic when the ducklings all approach.]

Cameron: There’s a problem.

House: Complications in surgery?

Foreman: Surgery went fine, he’s in recovery, but we took a vial of CSF and tested it.

House: Really?

Foreman: Turns out the bowing wasn’t the cause of his problems, it was a symptom.

Chase: Oligoclonal bands, and an increase of intrathecal IGG.

House: Which means multiple sclerosis. And the reason it takes three of you to tell me this?

Cameron: Because we’re having a disagreement about whether or not it is MS.

Chase: No lesions on the MRI.

Foreman: It’s early; he’s had the disease for maybe two weeks.

Cameron: McDonald criteria requires six months to make a definitive diagnosis.

House: Oh, who cares about McPherson? I hear he tortured kittens.

Foreman: McDonald.

House: Oh, McDonald. Wonderful doctor, loved kittens.

Foreman: The VEP indicates slowing of the brain.

Cameron: Without the lesions we can’t be sure.

House: Well if it is, it’s gone from 0 to 60 in three weeks, which would indicate rapidly progressive MS. Not the fun MS with the balloons and the bike rides for cripples in wheelchairs.

Cameron: We should wait until we [interrupted]

House: Start treating him now, he can walk for another couple of years, maybe live for another 5. Break it to the family. I’m going home.

[Cut to Dan’s room. Chase is there explaining about the whole MS thing]

Chase: It’ll take months for a definitive diagnosis.

Dan: What’ll happen to me?

Chase: MS is an incredibly variable disease, if it is MS, and we’re not 100% sure.

Dad: What do you think is gonna happen?

[Pause]

Chase: There are some medications to manage the symptoms, but as the disease progresses the problems will become more severe: bowel and bladder dysfunction, loss of cognitive function, pain.

Dan: It’s gonna hurt?

Chase: The brain’s like a big jumble of wires. MS strips them of the insulation, and the nerves die. The brain interprets it as pain, but by starting treatment we’re gonna avoid that for as long as possible. We’re looking into a couple specialists, and until we get you squared away you’ll stay here. Ok?

[It’s nighttime. A nurse is walking around with trays. The nurse enters Dan’s room, and he’s missing! Cut to Cameron walking over to Foreman.]

Cameron: Security checked the videotapes for all the perimeter cameras; he’s still gotta be in the hospital.

Foreman: Where’s Chase?

Cameron: Main floor.

Foreman: Ok, you take the cafeteria and administration. I’ll hit the research annex and work my way back to you.

[Chase is wandering around in a dark office. Cut to Cameron opening doors. Cuts back to Chase still looking around the offices. Cut to House’s apartment. He’s sitting in a chair brooding. There’s a TV show on in the background, but I can’t tell what it is. The phone keeps ringing and he pays it no attention except to glance over at the first ring. Cut back to Chase, still wandering around.]

Chase: Dan?

[Cut back to House’s apartment. Phone is still ringing. He gets up just as his machine comes on. He doesn’t make any attempt to answer the phone. He uses both arms to sort of lever himself out of what looks like a very comfortable chair.]

House’s answering machine: I’m not here. Leave a message.

[Cut to outside hospital. House is approaching, and Cuddy is leaving. See Cuddy opening the doors.]

House: Dr. Cuddy, great outfit.

Cuddy: What are you doing back here? Patient?

House: No, hooker. Went to my office instead of my home.

[House walks off and Cuddy leaves a little pissed off.]

[Cut to the elevator. Doors open and House steps out. He heads down a hallway, and is intercepted by Foreman.]

Foreman: Dr. House, Dan’s missing.

House: Yeah, I got that part from the message. You said I was needed immediately.

Foreman: He shouldn’t move after a lumbar puncture.

House: I agree, he’s gonna have a very nasty headache. That would also be my opinion if consulted tomorrow morning.

Foreman: We wanted to keep you informed. He heard some pretty heavy news.

House: [Sighs] This is not a toddler wandering around a department store. He’s 16. You’ll find him. I’m going home.

Foreman: So, when you say “Call me if you need anything,” You mean, “Don’t call me.”

House: No, I mean “Call me if I can do something.” I’m bad at search parties and I’m bad at sitting around looking nervous doing nothing.

Foreman: What about his parents? Should we call them?

House: Why? You think they’re hiding him? Make sure someone checks the roof; some of the orderlies keep the door propped open so they can grab a smoke.

[He gets back into the elevator, and goes home.]

[Cut to Foreman and Cameron running up the stairs. Another Cut puts us on an open field at night. Dan is standing there looking around. Suddenly Chase appears.]

Chase: Dan? You ok? [Pause] There are experimental treatments, ongoing research… Who knows what they’ll discover in a year or two?

Dan: This is where I dropped the ball.

Chase: Dan, we’re standing on the roof of the hospital! Dan! Dan, you’re not on the field!

[Cut to see Foreman and Cameron have arrived.]

Cameron: He doesn’t know where he is.

Foreman: Dan!

Chase: Foreman! [Chase motions that Foreman shouldn’t move just yet.]

Chase: Dan.

Cameron: Dan!

Foreman: Dan! No!

[Dan goes to step off the roof, and Chase tackles him.]

(La te da. Commercials. Evil.)

[Exterior of the hospital. It’s the next day.]

[House is standing at the elevator when Foreman comes down the steps.]

House: Dr. Foreman. I assume you found the kid.

Foreman: He almost walked off the roof.

House: Suicidal?

Foreman: No, he thought he was on his lacrosse field. Look, look, I was just gonna run home, shower, change… [interrupted]

House: Conscious?

Foreman: Yeah.

House: How’d you talk him down?

Foreman: Actually, Chase tackled him.

House: How come you didn’t do it?

Foreman: Right, well, I am black, but he was closer.

House: Come on, you can ride up with me.

[Foreman sighs and then gets into the elevator.]

[Cut to House’s office. Cameron and Chase are there.]

House: Anybody tell the family that their boy almost stepped off a roof? They must be thrilled.

Cameron: They’re not suing, but I think only because Chase asked them.

House: Why does everyone always think I’m being sarcastic? This is great news! He doesn’t have MS. The parents should be thrilled, well, the mom anyway. Of course, the dad probably doesn’t know… [interrupted]

Foreman: Why doesn’t he have MS?

House: He was on the roof thinking he was on the lacrosse field, conscious, and therefore not a night terror. You want some of this? [Asking Foreman about the coffee]

Foreman: Yeah, sure.

House: He was in an acute confusional state, which doesn’t fit with a demyelinating disease like MS.

Foreman: The Oligoclonal bands.

House: Were real. They just mean something other then MS. So, what are they telling us?

Chase: That the immune system is working.

House: Right, he has an infection in his brain.

Cameron: What about sex?

House: Well, it might get complicated. We work together. I am older, certainly, but maybe you like that.

Cameron: I meant maybe he has neurosyphilis.

House: Heh, nice cover.

Chase: Sorry, RPR was negative.

House: We don’t need a definitive test to confirm this.

Cameron: Sure, didn’t need one to confirm MS.

House: Ok, let’s wait for you to run titers on 4000 viruses while this kid’s brain turns to mush.

Foreman: So the fact that he doesn’t have MS is, it’s really not good news after all?

House: Well, it is if it’s neurosyphilis, the likelihood of a false negative on an RPR test, 30%, the likelihood of a 16 year old having sex, roughly 120%.

Cameron: I’ll start him on IV penicillin.

House: We’re not going to wait for that. The most effective way to deliver the drug is right into his brain via the spine.

Foreman: We can’t. In a cramped space like the brain, increased intracranial pressure from a high volume drug like penicillin could herniate his brain stem and kill him. No neurologist in his right mind would recommend that.

House: Show of hands. Who thinks I’m not in my right mind?

[No one raises their hand]

House: And who thinks I forget this fairly basic neurological fact?

[Again, no one raises their hand]

House: Who thinks there’s a third option?

[Chase raises his hand]

House: Very good, what’s the third choice?

Chase: No idea, you just asked if I thought there was one.

Foreman: [Sighs] The patient has a shunt in his brain. There’ll be no increased pressure, we can put as much penicillin into his body as we want.

House: Excellent, inject him through a lumbar puncture.

[Cut to Dan’s room, Foreman is there and Dan’s dad is there too]

Foeman: One of us is going to do this to you twice a day for the next two weeks.

Dan: [Sighs]

Dad: He could get syphilis even if he’s not sexually active?

[Dan looks at Foreman with sort of a pleading look on his face.]

Foreman: Well, it’s unusual, but it’s possible. Relax.

Dan: [Sighs again, and then grunts in pain]

[Cut to an exam room. There’s a guy with a really nasty pussy abscess on his knee. House backs off after he sees it.]

House: Geesh. It’s infected, with a really big hole like you stuck a nail in it to relieve the pressure.

Mr. Funsten: I wouldn’t do that.

House: Although the wound is irregular, not cylindrical, it’s shaped like a triangle, so not a nail. Steak knife?

Funsten: Wife’s nail file.

House: [Whispered] Nail File. Yeah, pain’ll make you do stupid things. Something to take the edge off? [Takes out his pills and puts one in his hand]

Funsten: Yeah.

House: Cheers. [Dry swallows the pill and Funsten eats his (ewwwww)] [Limps back over and sits on a rolly stool] So, do you have family here in Princeton?

Funsten: No.

House: Here on work?

Funsten: No, why are you- [interrupted]

House: Does your penis hurt?

Funsten: No. What? Should it?

House: No, just thought I’d toss you a really inappropriate question. Your lawyer’s gonna love it.

Funsten: Why would I want to sue you? I want you to treat me.

House: You’re from Maplewood, New Jersey. Right?

Funsten: Yeah.

House: Now, why would you drive 70 miles to get treatment for a condition that a 9 year old could diagnose? It’s the free flowing puss that’s the tip off.

Funsten: I was in town.

House: Not for family, not for work. You drove 70 miles to a walk-in-clinic. You passed two hospitals on the road. Now, either you have a problem with those hospitals, or they have a problem with you. My guess is that you’ve sued half the doctors in Maplewood, and the rest are now refusing to treat you. It’s ironic, isn’t it? It’s like the boy who sued wolf. You know what? I bet we have a doctor here named Wolfe. How perfect would that be? I’m gonna page him.

Funsten: Ok, you know what? Thank you, I’m gonna find a doctor to take care of this.

House: I didn’t say I wouldn’t treat you. We’ll drain your knee, run some lab work, fix you right up.

Funsten: Why would you do that?

House: I’m a people person.

[Cut to elevator. See House and Wilson exiting.]

Wilson: You actually treated him?

House: All I know is that he sued some doctors, who am I to assume that they didn’t have it coming to them. [Stops when he sees Cuddy coming] The cutest little tennis outfit, my God I thought I was going to have a heart attack.[Acts like he just realized that Cuddy was there.] Oh my, I didn’t see you there, that is so embarrassing.

Cuddy: How’s your hooker doing?

House: Oh, sweet of you to ask, funny story, she was going to be a hospital administrator, but hated having to screw people like that.

Cuddy: I heard you found her on the roof.

House: You have very acute hearing.

Cuddy: You notify the parents?

House: In due course, of course.

Cuddy: And is there a paternity bet on the father of the patient?

House: Doesn’t sound like me.

Wilson: Well, it does actually, but that doesn’t mean you’re guilty.

House: You think?

Cuddy: I saw the parents in the lobby, smart money is obviously on the father.

House: [Stage whisper] My guy knows a guy who can get you in for $50 bucks.

Cuddy: Fine. You tell your guy if I win, you attend the faculty symposium and you wear a tie.

House: And if I win, no clinic hours for a week.

Cuddy: My guy will call your guy.

[Cuddy walks off]

Wilson: She’s very good at her job.

[Cut back to Dan’s room. Chase is giving him his treatment. Cameron is at his head.]

Chase: The treatments should start helping soon. Let us know if it gets easier to focus on things, remember stuff.

[Dan is obviously in pain.]

Chase: Hey Dan, isn’t Dr. Cameron’s necklace a beauty? Something South American, I think.

Cameron: Yeah, Guatemalan.

Dan: It’s a cool necklace.

[She looks down and sees that it’s in a very revealing spot.]

Cameron: Thank you so much.

Chase: The kid’s in pain.

Cameron: [Scoffs]

Male Voice 1: Don’t fight it.

Male Voice 2: Just let it happen.

Dan: No.

Chase: No, what?

Female Voice 1: You’ll be dead in three days.

Female Voice 2: I give it a day.

Chase: Dan? You ok?

Cameron: Dan?

[Dan starts shaking]

Cameron: He’s hearing voices.

[As this is going on the voices taunt Dan with sayings. They are all telling him that he’s gonna die.]

Chase: [muffled] Dan? [Regular] Push three milligrams IV, stat!

Cameron: Come on Dan!

Dan: [screaming] GET OUT OF MY HEAD!

(Commercials)

Cameron: Auditory hallucination shows further brain degeneration.

Chase: Penicillin’s not working.

House: So, either it’s a bad batch of penicillin, or our diagnosis is wrong. Square one. “Mignight.”

[House writes M,I,D,N,I,T on the white board]

Foreman: LFTs, BUN, and creatinine, are all normal, diabetes is out. No gap.

House: There goes metabolic. [Crosses off “M”]

Cameron: MRI rules out vasculitis.

House: “I” for inflammation. [Crosses out the “I”]

Chase: To young for anything degenerative.

House: “D”, see ya. [Crosses out the “D”] “N” for neoplastic?

Chase: MRI was clean.

[House crosses out the “n”]

House: “I” for inflammation.

Cameron: We already did that.

House: Stupid to have two I’s in one mneumonic. What’s the other one?

Foreman: Infection.

Cameron: Oligoclonal bands still have to mean something.

Foreman: But no fevers; white count’s elevated but within range.

Chase: And we’ve tested for anything remotely possible. Everything is negative.

[House crosses out the other “I”]

Cameron: CT scan rules out subdural.

House: Trauma, later much. [Looks at the board which is now all crossed out.] You know the problem? Midnight is actually spelled with a “G” and an “H,” If we could just figure out what those two letters stand for. [Sighs and walks away for the board. His back is now facing the ducklings] It’s a sick brain, having fun, torturing him, talking to him. [pause] Scaring the hell out of him. Get him an EEG, left and right EOG esophageal microphones. If this thing wants to talk, let’s listen.

[Cut to outside day. Almost continued from the last scene. House is sitting with Wilson.]

House: We’re missing something. This is screwed up.

Wilson: That’s why you came up with the brain talking to the virus thing?

House: I panicked, ok? Sounded cool though, they bought it.

[House sees Dan’s parents walking his way.]

House: Oh, crap. Another reason I don’t like meeting patients. If they don’t know that you look like they can’t yell at you. [Aside to Wilson] Here we go.

Mom: How can you just sit there?

House: If I eat standing up, I spill.

Dad: Our son is dying, and you could care less? We’re going through hell- you’re doing nothing?

House: I’m sorry, you need to vent, I understand.

Dad: Don’t be condescending. You haven’t checked in on him once.

House: Blood pressure’s 110/70, the shunt is patent well placed in the right lateral ventricle, the EKG shows a normal QRS with deep wave inversions throughout both limb and pericardial leads. LFTs are elevated but only twice the normal range. Oh yeah, and he’s hearing voices. [Pause] Go hold his hand. Go on. I’ll bus your tray.

[They walk off holding hands]

House: Got any sample bags on you?

Wilson: I don’t believe you. You’re gonna run DNA tests?

House: Their son is deathly ill, I know it’s terrible, but the fact is if I don’t keep busy with trivial things like this I’m afraid I might start to cry.

Wilson: You’re an ass.

House: Yeah? You want to double the bet?

[Cut to Cameron and Foreman in a lab. House enters.]

House: General Hospital is on channel 6.

Foreman: Dan’s brain’s not showing channel 6 right now, only mush.

House: No epileptiform activity. [Turns to Cameron] What are you doing?

Cameron: Waiting for CBC and Chem-7.

House: Good, run DNA on these. [He puts down two cups that are labeled “Mommy” and “Daddy???”]

Cameron: What’s this?

House: Parents’ coffee cups.

Cameron: I can’t believe you [interrupted]

House: I’ve had this conversation once already. If you’ve got something else to do, do it. Otherwise, do this.

[Cut to House in hallway.]

Funsten: Dr. House?

House: Hey, Mr. Funsten! I was wondering when you’d be back. Got some papers for me?

Funsten: You’ve caused me considerable mental distress.

House: I certainly hope so. [Funsten hands him an envelope] What? Too cheep to have your lawyer serve it for you, or is it more fun this way?

Funsten: I’m obviously prepared to consider a settlement.

House: You have gonorrhea.

Funsten: No, I don’t! House: Well, maybe you’re right, but I have a lab result that says you do. It could be a false positive; normally I’d run a second test, but since you’re here I’ll just go with the first.

Funsten: You’re just trying to scare me.

House: It’s reportable you know, public health issue.

Funsten: I’ll be sure to let my wife know.

House: Oh, don’t bother yourself, the state will call for you. Look, if you’re clean I’m sure this will all blow over, no big deal. There’s an easy way to find out, get one of your doctors run a test.

[Funsten grabs for the papers, but House snatches them away.]

House: Uh-uh. These are mine now. I’ll see you in court. [House enters the elevator.]

[Cut to Chase, Foreman, and Cameron in a lab.]

Foreman: West Nile negative, not surprising, since not too many mosquitoes passing through Jersey in December.

Chase: No Eastern Equine Encephalitis.

Cameron: You guys aren’t going to believe this.

Chase: What’s that?

Cameron: House was right, the father’s not the father.

Foreman: [Sighs] Dude doubled up on me.

Chase: You’re not gonna believe this, the mother’s not the mother either.

[Cut to Cuddy’s office. Dan’s parents are there.]

Cuddy: It’s not a good idea to move your son in his condition.

Mom: We just want a second opinion.

Dad: We need an answer.

[House comes into the office.]

House: You idiots! You lied to me!

Dad: We didn’t lie about anything. You, on the other hand, accused us of molesting our son.

Cuddy: Perfect.

House: Can we get off my screw-ups and focus on theirs? Theirs is bigger. You’re not Dan’s parents.

Mom: We’re his parents.

Dad: He was adopted. He doesn’t need to know.

House: I do.

Dad: Adoption makes him just as much his- [interrupted]

House: Listen, when we were taking his medical history, were you confused? Did you think we were looking for a genetic clue to his condition, or did you think we were trying to ascertain who loves him the most in the whole wide world?

Cuddy: How did you find out about this?

House: I sampled their DNA.

Dad: We didn’t give you any DNA.

House: Your coffee cups from the cafeteria.

Cuddy: You can’t do that! House: Again, why are we getting hung up on what I did? [Turns to Dan’s parents] Your medical history is useless.

Dad: No, we gave you a detailed history of his biological mother.

Mom: Her history; non-smoker, good health, low cholesterol, no blood pressure problems.

Dad: Dan was adopted two weeks after he was born. You have his history. There’s nothing you need to know that we didn’t tell you.

Cuddy: Sounds reasonable. Well, if you want to transfer your boy that is your choice, but I still think it’s the wrong- [interrupted]

House: Was she vaccinated? [Pause] The biological mother, when she was a baby, did she get her vaccinations?

Dad: Dan was vaccinated at 6 months.

House: Mm hmm, and do you know why kids get vaccinated at 6 months? Because before that, they are protected by their biological mother’s immune system. So, was she vaccinated?

[Cut to a scene with a cool looking round thing with green prongs (it’s the measles virus) and it overlaps the speech that House makes. It travels around and then there is a cut inside of it and you can see a double helix of DNA breaking or “unzipping”.]

House: An infant picks up a regular old measles virus. He gets a rash, he’s extremely uncomfortable, has a wicked fever, but he lives. Here’s the kicker, once every million or so times, the virus mutates. [Cut to House’s office. House and the ducklings are there] Instead of Dan having a fever and a rash the virus travels to his brain and hides like a time bomb. In this case for 16 years.

Foreman: Sub-acute Sclerosing Pan-encephalitis.

House: I know. There’s only been 20 cases in the United States in the past 30 years.

Foreman: I suppose you could make an argument that the kid’s still in stage one. Once SSPE moves to stage two [Interrupted]

House: Boom, stage two is universally fatal.

Cameron: I assume it’s impossible to tell when he might move into stage two.

House: He’s already started showing symptoms. It could be a month, it could be tonight.

Cameron: Can we treat it?

House: Ask the neurologist.

Foreman: Intraventricular interferon.

Chase: We’re not gonna shove a spike into his brain and drip interferon without confirming this diagnosis.

House: Tap him.

Foreman: We won’t get a reliable result for measles antibodies in his CSF, not after everything we’ve given him.

House: So the wrong treatment kills any hope of the right diagnosis. Why do people lie to me? [Pauses and sighs] It could also kill him. Your ball, Foreman, tell me I don’t have to biopsy his brain.

Foreman: [Sighs] Well, there is one other way.

[Cut to a room and there is Dan with a HUGE needle pointing at his right eye.]

Dan: You sure this isn’t gonna hurt?

Foreman: Yeah, it’s just scary as hell. See, we go through the pupil. You won’t feel it; the eye’s been paralyzed. The needle travels to the back of the eye which is where we perform the biopsy on your retina.

[Cut to the needle entering Dan’s eye with a really cool sound. You can see the measles virus from the previous cut scene sitting there and then getting sucked up.]

Foreman: So we’ve confirmed that the problem is this mutated virus. The treatment for SSPE is intra-ventricular interferon. We implant an Ommaya reservoir under the scalp, which is connected to a ventricular catheter that delivers the antiviral directly to the left hemisphere [interrupted]

Dad: Look, you want us to consent to this? I don’t even understand what you’re talking about.

Foreman: Well, the antiviral…[pauses] Look, I’m sorry, I can explain this as best I can, but the notion that you’re gonna fully understand your son’s treatment and make an informed decision, is, it’s kinda insane. Now, here’s what you need to know, it’s dangerous, it could kill him, you should do it.

[Cut to operating room. Dan is awake on the table, we can see a doctor with a drill standing behind him. Cameron and Foreman is there, I’m not sure about Chase. Cut to a screen next to the operating table and you can see the drill make a hole in Dan’s skull.]

[Cut to Cuddy’s office]

Cuddy: You can’t order a $3,200 DNA test to win a bet.

House: It’s not an actual cost. I don’t know if you know this, but the hospital actually owns the sequencing machine.

Cuddy: I’m serious.

House: Well, tell the parents to submit the bill to insurance.

Cuddy: Insurance is not going to pay for a bet.

House: It should. If we don’t make that bet, the kid dies. If not for the paternity bet, I never would have taken their DNA, without their DNA we never would have discovered that Dan was adopted, which was the key to this case. You just don’t want to pay your end. Big mistake. My guy knows a guy.

Cuddy: Fine. I will let you out of clinic duty for one week, after you pay the $3,200 for the PCR test.

[House sighs and picks up his cane. He limps over to her desk, and slams his cane down.]

Cuddy: Whoo.

House: Well now, there’s the $100 you owe me, there’s the $100 I won from Cameron, $200 I took off of Foreman, and $600 I got from Wilson. Very bitter.

[Cut to Dan’s room. Foreman is there and so is Cameron. I’m guessing it’s the next day. Dan wakes up.]

Cameron: Hey, good morning.

Foreman: Good news on your EEG, treatment is working.

Cameron: And your immune system is responding.

Foreman: I know it’s early, but let me take a look. Let’s see what that brain of yours can do. Name as many animals as you can that start with the letter “O”.

Dan: Ostrich, ox, old elephant.

Cameron: Well, that’s 2 better then last time. How you doing with the whole adoption thing?

Dan: I knew since 5th grade.

Foreman: How’s that?

Dan: Cleft chin. I have one, my dad doesn’t. I looked it up on the Internet; it’s one of those trait things.

Forman: That’s right, it’s autosomal dominant. Since neither of your parents have cleft chins, it’s highly unlikely that you’re biologically related.

Cameron: You sure you’re ok?

Dan: I’ve got no problems with being adopted. I love my parents.

[Dan’s parents enter.]

Dad: How’s he doing?

Cameron: He’s doing pretty well. He’s a smart kid. I think he’s gonna be fine.

Dad: Thanks.

[Cut to a lacrosse game on a field. House is standing on the sidelines.]

House: Wheels, one-eight! Wheels!

[18 makes a goal. House’s hand moves with the player’s movement, and House gives a small smile. The team all gathers around and cheers together. House picks up his cane and holds it like a lacrosse stick. Cut around House and see that there’s no one there. He limps out onto the field.]


END

Season 1 X 01: Pilot

Original Airdate: 11/16/2004
Written by: David Shore
Directed by: Bryan Singer

BEGINNING

(A panning shot of a city street followed by a pretty woman- called "Rebecca"- sitting on a bus. She's then shown running over a bridge at top speed, carrying a suit case. She then runs down a sidewalk and into her work place, an elementary school, just as the bell is ringing.)

Melanie: Why are you late?

Rebecca: You're not gonna like the answer.

Melanie: I already know the answer.

Rebecca: I missed the bus!

Melanie: I don't doubt it. No bus stops near Brad's. You spent the night, the alarm didn't work or maybe it did.

Rebecca: (in a hushed voice) I didn't sleep with him. I missed the bus!

Melanie: Either there's something very wrong with him or there's something very wrong with you.

Rebecca: There's nothing wrong with him.

Melanie: Please tell me you know that for a fact.

Rebecca: Melanie, I gotta go. (heads into her classroom)

Melanie: You're lying, aren't you?

Rebecca: (over her shoulder) I wouldn't lie to you! (to her five-year-old students) Good morning!

Students: Good morning, Miss Rebecca! (awwww)

Rebecca: Everybody's in their seats? (goes to her desk and takes off her coat) Sydney, why don't you tell us what you did this weekend?

Sydney: (smiles shyly)

Rebecca: Come on, Sydney. We know you're not shy.

Sydney: How come we always have to tell you what we did and you don't tell us what you did?

Rebecca: Okay... I had a really great weekend. But you can't tell Miss Melanie, okay?

Student 2: What did you do?

Rebecca: I made a new friend. It's so much fun to make new friends, isn't it?

Students: Yeah.

Student 2: Did you tell your mom and dad about your new friend?

Rebecca: Absolutely. You should never keep anything from your parents. And I told my hack-buh (Rebecca's speech suddenly becomes extremely slurred and the students giggle a bit.) Whach. (more giggles from the children) Hullbucha. (She is looking worried now) Plah. Calpa. (She is beginning to get dizzy and heads to the white board, using her desk and chair to steady herself) Hullbucha. (She frantically starts writing something on the white board and the children read what she's writing)

Students: C-A-L-H-E.

Sydney: The! We know that word, the!

(Rebecca falls to the floor and Melanie peers in through the window in the door. The students rush over to her and Melanie rushes in. Rebecca is seizing on the floor and the camera pans back to the white board where Call The Nurse is written is messy priting)

(Opening credits)

(Screen is black but we can hear the voice of Dr. Wilson.)

Wilson: Twenty-nine-year-old female, first seizure one month ago, lost the ability to speak, babbled like a baby, progressive deterioation of mental status.

(The screen has now faded from black to the hall in a hospital where Dr. Wilson and Dr. House are walking together- you can just see the backs of their legs though.)

House: See that? They all assume I'm a patient because of this cane.

Wilson: So put on a white coat like the rest of us.

House: I don't want them to think I'm a doctor.

Wilson: You see why the administration might have a problem with that attitude.

House: People don't want a sick doctor.

Wilson: Fair enough. I don't like healthy patients. The twenty-nine-year-old female-

House: The one that can't talk? I like that part.

(Camera pans up so we finally see Wilson's face.)

Wilson: She's my cousin.

(The camera than shows- cue dramatic music please- Dr. House)

House: And your cousin doesn't like the diagnosis. I wouldn't either. Brain tumor. She's gonna die. Boring. (goes to leave, Wilson follows him)

Wilson: No wonder you're such a reknowned diagnostician. You don't need to actually know anything to figure out what's wrong.

House: You're the oncologist. I'm just a lowly infectious disease guy.

Wilson: Ha. Yes, just a simple country doctor. Brain tumor's at her age are highly unlikely.

House: She's twenty-nine. Whatever she's got is highly unlikely.

Wilson: The protein markers for the three most prevalent brain cancers came up negative. (flips folder over and House glances at it quickly)

House: It's an HMO lab. Might as well have sent it to a high school kid with a chemistry set.

Wilson: No family history.

House: I thought your uncle died of cancer.

Wilson: Other side. No environmental factors.

House: That you know of.

Wilson: And she's not responding to radiation treatment.

House: None of which is even close to dispositive. All it does is raise one question: your cousin goes to an HMO? (pops a couple Vicodin)

Wilson: Come on. Why leave all the fun for the coroner? What's the point of putting together a team if you're not gonna use them? You've got three over-qualified doctors working for you, getting bored.

(House looks pensive.)

(Screen goes black and fades to Rebecca's hospital room where shje is laying in bed with sleeping and the camera zooms up her nostril. Insert CGI clip of what's going on inside her head- there's a bit with some blood vessels and a big gray thing that is probably her brain. This fades out and takes us to the X-ray of her head while House studies it.)

Foreman: (off camera) It's a lesion.

House: And the big green thing in the middle of the bigger blue thing on a map is an island. (walks away from X-ray and the camera pans away to display Foreman, Cameron and Chase, looking at the X-ray too) I was hoping for something a bit more creative.

Foreman: Shouldn't we be speaking to the patient before we start diagnosing?

House: Is she a doctor?

Foreman: No, but-

House: Everybody lies.

Cameron: (to Foreman in a hushed voice) Dr. House doesn't like dealing with patients.

Foreman: (to Cameron) Isn't treating patients why we became doctors?

House: No, treating illnesses is why we became doctors. Treating patients is what makes most doctors miserable.

Foreman: So, you're trying to eliminate the humanity from the practice of medicine.

House: If we don't talk to them, they can't lie to us. And we can't lie to them. Humany is overrated. (looks at X-ray again) I don't think it's a tumor.

Foreman: First year of medical school- if you hear hoofbeats, you think horses, not zebras.

House: Are you in first year medical school? (Foreman looks uncomfortable.) No. First of all, there's nothing on the CAT scan. Second of all, if this is a horse than her kindly family doctor in Trenton makes the obvious diagnosis and it never gets near this office. Differential diagnosis, people. If it's not a tumor, what are the suspects? Why couldn't she talk?

Chase: Aneurysm, stroke or some other ischemic syndrome.

House: Give her a contrast MRI.

Cameron: Creutzfeld-Jakob disease.

Chase: Mad cow?

House: Mad zebra.

Foreman: Wernickie's encephalopathy?

House: No. Blood thiamine level was normal.

Foreman: Lab in Trenton could have screwed up the blood test. I assume it’s a corollary if people lie, that people screw up.

House: Re-draw the blood tests and get her scheduled for that contrast MRI ASAP. Let’s find out what kind of zebra we’re treating here.

(Camera pans in on Rebecca in her room. We then get a close-up shot of House waiting for the elevator. Cuddy walks swiftly in his direction and he pushes on the elevator button impatiently but Cuddy reaches him before the elevator arrives.)

Cuddy: I was expecting you in my office twenty minutes ago.

House: Really? That's odd because I had no intention of being in your office twenty minutes ago.

Cuddy: (with hand on hip) You think we have nothing to talk about?

House: Nope. Just can't think of anything I'd be interested in.

Cuddy: I sign your paychecks.

House: I have tenure. (Elevator opens and House goes to step in while the other people inside get out. House looks at Cuddy.) Are you gonna grab my cane now, stop me from leaving?

Cuddy: That would be juvenile.

(House steps into the elevator, presses the button and Cuddy follows him inside and smiles innocently up at him- a most perfect expression if I do say so myself.)

Cuddy: I can still fire you if you're not doing your job.

House: I'm here from nine to five.

Cuddy: Your billings are practically non-existant.

House: Rough year.

Cuddy: You ignore requests for consults.

House: I call back sometimes. Sometimes I misdial.

Cuddy: You're six years behind on your obligations to this clinic.

House: See, I was right. This doesn't interest me.

Cuddy: Six years times three weeks. Y'owe me better than four months.

House: It's five o'clock. I'm going home. (Elevator opens and House heads out.)

Cuddy: To what?

House: Niiice.

Cuddy: (going after House) Look, Dr. House, the only reason why I don't fire you is because your reputation is still worth something to this hospital.

House: Excellent. We have a point of agreement. You're not gonna fire me.

Cuddy: Your reputation won't last if you don't do your job. The clinic is part of your job. I want you to do your job.

House: But as the philosopher Jagger once said, 'you can't always get what you want'. (walks away leaving Cuddy looking rather dumb-founded and frustrated)

(We now get a nice panning shot of the Princeton-Plainsboro Teaching Hospital, the first of many.)

(We then see the team taking an ill-looking Rebecca, sitting in a wheelchair, somewhere in a wheelchair.)

Rebecca: (to Chase) You're not my doctor. Are you, Dr. House?

Chase: Thankfully no. I'm Dr. Chase.

Cameron: Dr. House is the Head of Diagnostic Medicine. He's very busy but he has taken a keen interest in your case.

(Rebecca looks around sorrowfully.)

(Shot of a vial of medicine being pumped into a syringe by Foreman.)

Foreman: We inject gadolinium into a vein. It distributes itself throughout your brain and acts as a contrast material for the magnetic resonance imagery.

(We see Rebecca laying in the MRI machine table with Cameron adjusting some switches.)

Cameron: Basically whatever's in your head lights up like a Christmas tree.

Foreman: It might make you feel a little light-headed.

Nurse: Dr. Cameron. (we see a nurse- or somebody- outside the MRI room) I'm sorry but I have to stop you. There's a problem.

(Cameron and Foreman look at one another. We then see a shot of House bursting into Cuddy's office and he doesn't look amused.)

House: (shouting) You pulled my authorization!

Cuddy: Yes. Why are you yelling?

House: No MRIs, no imaging studies, no labs.

Cuddy: You also can’t make long distance phone calls. (fiddles with some papers at her desk)

House: If you're gonna fire me, have the guts to face me.

Cuddy: Or photo copies. (looks up at him) You're still yelling.

House: I'M ANGRY. You're risking a patient's life.

Cuddy: I assume those are two separate points.

House: You showed me disrespect. You embarrassed me and as long as I work here, you-

Cuddy: Is the yelling designed to scare me because I'm not sure what I’m supposed to be scared of. More yelling? That’s not scary. That you’re gonna hurt me? That’s scary but I’m pretty sure I can out-run ya. (gets up) Oh, I looked into the philosopher you quoted- Jagger. You're right. You can't always get what you want but as it turns out, if you try sometimes you can get what you need.

House: So. (takes out Vicodin bottle) 'Cause you want me to treat patients, you're not letting me treat patients.

Cuddy: I need you to do your job.

(House pops a couple Vicodin and he leaves Cuddy's office and meets the team... who are all, oddly, standing in a group like a bunch of... well, ducklings.)

House: Do the MRI. She folded.

(Foreman, Chase and Cameron exit, leaving Wilson and House.)

House: (sigh) I've gotta do four hours a week in this clinic, 'til I make up the time I've missed... 2054. I'll be caught up in 2054. (walks away and looks back at Wilson) You better love this cousin a whole lot.

(Shot of Rebecca being lowered onto the MRI table once again and all the MRI stuff is done. She's slid inside and the ducklings gather outside the MRI room.)

Cameron: (into microphone) Alright, Rebecca, I know you might feel a little claustrophobic in there but we need you to remain still. (We get a close-up of Rebecca and she honestly looks terrified.)

Chase: (into microphone) Okay, we're gonna begin.

(Another shot of the inside of the MRI. We hear a few clicking and thumping sounds. I don't know how they work so bear with me.

Rebecca: I don't feel so good.

Chase: It's alright. Just try to relax.

(Rebecca starts making sounds like she's finding it hard to breathe.)

Cameron: Rebecca?

(Shot of Rebecca fighting for air with her mouth wide open.)

Cameron: Rebecca.

(Shot does into Rebecca's mouth and down her throat where we see her throat lose completely. Rebecca passes out.)

Cameron: Rebecca! (to Chase) Get 'er out of there. (stands up)

Chase: She probably fell asleep. She's exhausted.

Cameron: She was claustrophobic thirty seconds ago, she's no sleeping. We gotta get her out of there. (a bunch of people follow her inside the MRI room- who are these people? Nurses?)

Chase: (still sitting) It'll just be another minute.

Cameron: (pushes a button on the MRI machine and the table slides out.) She’s having an allergic reaction to gadolinium- she’ll be dead in two minutes.

Foreman: Hold her neck. (Cameron and Foreman pull her out.)

Cameron: Oh, she's ashen.

Foreman: (lowers his ear to her mouth) She's not breathing. Epi point five.

Cameron: Come on. (inserts a thingy into her mouth and pumps it a few times) I can't ventilate.

Foreman: Too much edema. Where's the surgical airway kit?

Chase: Yup, coming.

(Cameron pushes a syringe of something into Rebecca and they prep her throat. Chase makes a cut in the throat- ew!- and they insert a tube into her throat. There's a bit of blood spurting here and there and a couple close-up shots of Chase's baby blues. They hook the breathing pump thingy to the tube thingy and Cameron pumps it a few times.)

Chase: (to Cameron) Good call.

(We see a shot of House popping open his Vicodin bottle. He seems to do a lot of that in this episode. He pops a couple.)

(Shot switches to Cameron checking Rebecca's vitals.)

Chase: We'll get that tube out of your throat later today.

Cameron: Just get some rest for now, okay?

(Rebecca nods weakly and the team meets House in the hall.)

House: Told you. Can't trust people.

Cameron: She probably knew she was allergic to gadolinium- figured it was an easy way to get someone to cut a hole in her throat.

House: Can't get a picture, gonna have to get a thousand words.

Foreman: You actually want me to talk to the patient? Get a history?

House: We need to know if there's some genetic or environmental cause that's triggering it off an inflammatory response.

Foreman: I thought everybody lied.

House: Truth begins in lies. Think about it. (walks away)

Foreman: (to his fellow ducklings) That doesn't mean anything, does it?

(We are now in the most dreaded place in the whole hospital- the clinic. House walks in.)

House: (to receptionist) 12:52 PM, House checks in. Please write that down. Do you have cable TV here somewhere? (Cuddy is closing in on him from behind but House is unaware.) General Hospital starts in eight minutes.

Cuddy: (while flipping through a file) No TV but we've got patients.

House: Can't you give out the Aspirin yourself? I'll do paperwork-

Cuddy: I made sure your first case was an interesting one.

House: (in a mocking tone) Cough just won't go away, runny nose looks a funny color.

Cuddy: Patient admitted complaining of back spasms.

House: I think I read something like that in the New England Journal of Medicine.

Cuddy: Patient is orange.

House: The color?

Cuddy: No, the fruit. (looks at chart)

House: You mean yellow. It's jaundice.

Cuddy: I mean orange.

House: Well, how orange? It's probably-

Cuddy: (thrusts the chart at House) Exam room one. (leaves)

(We are now looking at a man in his fifties in the exam room and his skin is actually orange-tinted. He's playing with his wedding band as he explains his illness to House.)

Orange Man: I was playing golf and my cleats got stuck. I mean, it hurt a little bit but I kept playing. (Shot of House grinning to himself.) Next morning I could barely stand up. Well, you're smiling so I take it this isn't serious. (House takes out his Vicodin.) What's that? What are you doing?

House: Pain killers. (pops a couple)

Orange Man: Oh. For you, for your leg.

House: No, because they're yummy. Want one? Make your back feel better. (Hobbles over to him and gives him one. Aww. You see? Sharing is nice!) Unfortunately, you have a deeper problem. You wife is having an affair.

Orange Man: What?!

House: You're orange, you moron! It's one thing for you not to notice but if your wife hasn't picked up on the fact that her husband has changed color, she's just not paying attention. By the way, do you consume just a ridiculous amount of carrots and mega dose vitamins? Carrots turn you yellow, the niacin turns your red. Find some finger paint and do the math. (opens the door to leave) And get a good lawyer. (exits, leaving Orange Man looking stunned)

(House is with his second clinic patient and putting a stethoscope to a young boy's back.)

House: Deep breath.

Boy: It's cold.

House: (to Boy's mom) Has he been using his inhaler?

Boy's Mom: Not in the past few days. He's only ten. I worry about children taking such strong medicine so frequently. (House looks at her like he wants to reach over and slap her.)

Boy: What happened to your leg?

House: Your doctor was probably concerned about the strength of the medicine, too. She probably weighed that danger against the danger of not breathing. (grins at the shocked-looking mother) Oxygen is so important in those pre-pubescent years, don't you think? (takes a deep breath) Okay, I'm gonna assume nobody's ever told you what asthma is- or if they have, you had other things on your mind. A stimulant triggers cells in your child's airways to release substances that inflame the air passages and cause them to contract. Mucus production increases, the cell lining starts to shed. But the steroids... the steroids... (House's eyes glaze over as the tiny cogs in his brain start turning.) ...stop the inflammation. More often this happens... (House goes for the door)

Boy's Mom: What? More often this happens what?

House: Forget it. You don't trust steroids, you shouldn't trust doctors. (he closes the door behind him and Boy's Mom and Boy look at one another)

(We're back in Rebecca's room.)

Rebecca: My mother passed away four years ago. She had a heart attack and my father broke his back doing construction.

(Cameron's pager goes off.)

Cameron: (to Foreman) It's House. It's urgent. (to Rebecca) I'm sorry. (they leave and see that House is just outside the door) You couldn't have knocked?

House: Steroids. Give her steroids. High doses of prednisone.

(Rebecca looks up and tries to see who Foreman and Cameron are speaking to outside her room. All she can see is his prodile and the shadow of a cane. Ooh. Mysterious. She puts her head back down on the pillow.)

Foreman: You’re looking for support for a diagnosis of cerebral vasculitus.

Cameron: Inflammation of blood vessels in the brain is awfully rare, especially for someone her age.

House: So is a tumor. Her SED rate was elevated.

Foreman: Mildly.

Cameron: That could mean anything or nothing.

House: Yeah. I know. I have no reason to think that it's vasculitus. Except that it could be. If the blood vessels are inflammed, that's gonna look exactly like what we saw in the MRI from Trenton County and the pressure's gonna cause neurological symptoms.

Cameron: We can't diagnose that without a biopsy.

House: Yes we can. We treat it. She gets better, we know we're right.

Cameron: And if we're wrong?

House: Than we learn something else.

(Panning shot of hospital. What a pretty hospital it is.)

(Back in Rebecca's room. Chase is shining a light into her eye.)

Rebecca: (in a scratchy voice; there is now a bandage over her throat) Why steroids?

Chase: Just part of your treatment. You haven't had many visitors. No boyfriend?

Rebecca: Three dates. I wouldn't have stood by him if he were vomiting all day.

Chase: What about work? You must have friends from work?

Rebecca: Pretty much everybody I like is five-years-old. The nurse said you're stopping my radiation.

Chase: We're just trying some alternative medications. So, where's your family from-

Rebecca: Steroids are not an alternative to radiation.

Chase: The tests weren't really conclusive.

Cameron: We're treating you for vasculitus. It's the inflammation of blood vessels in the brain. (glances at Chase)

Rebecca: It's not a tumor? I don't have a tumor?

(Chase follows Cameron out of the room.)

Chase: Hey. You should've told her the truth, it's a long-shot guess.

Cameron: (to nurse at desk) Thank you. (to Chase) If House is right, no harm. If he's wrong, I've given a dying woman a day's hope.

Chase: False hope.

Cameron: If there was any type available, I would've given her that.

(Cameron walks away and Chase goes in the opposite direction.)

(We then get a shot of Foreman putting his nose to the floor of Rebecca's classroom)

Sydney: Why are you smelling Billy's pants?

Foreman: (gets up on his knees) I'm not.

Sydney: Looked like you were.

Foreman: I was smelling the floor.

Sydney: Oh.

Foreman: Do you have any pets in this class?

Sydney: No but we used to have a gerbil but Carly L dropped a book on it.

Foreman: (shrugs) Careless.

Sydney: Do you need to smell it?

Foreman: No, I'm smelling for mold. I don't need to smell it.

Sydney: You can smell our parrot.

Foreman: You said you didn't have any pets in this class.

Sydney: A parrot is a bird.

(Shot of a TV with a soap opera playing on it.)

Foreman: (his voice, anyway) Parrots are the primary source of psitticosis.

(Shot of House watching the TV at a cafeteria table with Foreman sitting across from him.)

House: It's not the parrot.

Foreman: Psitticosis can lead to (looks up at TV and looks back at House) nerve problems and neurological complications.

House: How many kids were in the class?

Foreman: Twenty.

House: How many are home sick?

Foreman: None but-

House: None but you figured that five-year-olds are more serious about bird hygene than their teacher. (looks back up at TV) Been through her home?

Foreman: She lives in Trenton. I can go up to her room tomorrow morning and ask her for the key.

House: (looks taken aback) Would the police call for permission before dropping by to check out a crime scene?

Foreman: It's not a crime scene.

House: Far as I know, she's running a meth lab out of her basement.

Foreman: She's a kindergarten teacher!

House: And if I were a kindergarten student, I would trust her implicitly... (looks behind him) Okay, I'll give you a for-instance. (shot of cafeteria worker rubbing her nose on her glove) Lady back there (looks back at Foreman) who made your egg salad sandwich, her eyes looks glassy, did you notice that? Hospital policy is to stay home if you're sick but if you're making eight dollars an hour, than you kinda need the eight dollars an hour, right? (Foremans looks suspiciously at his sandwich.) The sign in the bathroom says that employees must wash after using the facilities but I figure someone who wipes snot on a sleeve isn't hyper-concerned about sanitary conditions. So, what do you think? Should I trust her? (looks back up at TV) I want you to check the patient's home for contaminants, garbage, medication-

Foreman: I can't just break into someone's house.

House: Isn't that how you got into the Felker's home? (Foreman's face goes blank. House looks back at him.) Yeah, I know. Court records are sealed, you were sixteen, it was a stupid mistake. But your old gym teacher has a big mouth. Should write a thank-you note.

Foreman: I should thank him?

House: Look, I needed somebody around here with street smarts. Okay? Knows when they'r being conned, knows how to con.

Foreman: I should sue you.

House: I'm pretty sure you can't sue somebody for wrongful hiring.

Foreman: But I'm pretty sure I can sue for if you fire me for not breaking into some lady's house. (He eats the rest of the sandwich cooly, as to show that yes, he does trust the cafteteria woman. Ooh. How daring.)

(Shot of the front of a magazine. House is reading it in the exam room and Cuddy finds him.)

House: Research. People are fascinating, aren't they?

Cuddy: Why are you giving Adler Steroids?

House: Because she's my patient. That's what you do with patients, you give them medicine.

Cuddy: You don't prescribe medicine based of guesses. At least we don't since Tuskeegee and Mengele.

House: You're comparing me to a Nazi? Nice.

Cuddy: I'm stopping the treatment. (she leaves and House goes after her)

House: She's my patient.

Cuddy: It's my hospital.

House: I did not get her sick! She's not an experiment. I have a legitimate theory of what's wrong with her.

Cuddy: With no proof!

House: There's never any proof. Five different doctors come up with five different diagnosies based on the same evidence.

Cuddy: You don't have any evidence! (pushes the elevator button) And nobody knows anything, huh? Than how is it that you always think you're right?

House: I don't. I just find it hard to operate on the opposite assumption. Why are you so afraid of making a mistake?

Cuddy: Because I'm a doctor. (walks away and takes the stairs instead of the elevator) Because when we make mistakes, people die.

House: Come on. (House goes after her but stops at the foot of the stairs) People used to have more respect for cripples, y'know. (to a nearby person in a wheelchair) They didn't really.

(Cuddy comes into Rebecca's room)

Cuddy: So how are you feeling?

Rebecca: (who is eating her lunch) Much better, thanks. Are you Dr. House? I thought he was a he but...

Cuddy: No... Don't eat too much too fast.

Rebecca: (nods) Thank him for me.

Cuddy: Right. (leaves and finds House waiting outside, to her surprise)

House: Should I discontinue the treatment, boss?

Cuddy: You got lucky.

House: (watches her walk away) Cool, huh?

(Another panning shot of the hospital, this time at night. This is followed by going back into Rebecca's room where Wilson is with her, checking her airways with a stethoscope to her back.)

Wilson: Okay, once again. (Rebecca takes a deep breath and exhales.) Good.

Rebecca: Am I ever gonna meet Dr. House?

Wilson: You might run into him at the movies or on the bus.

Rebecca: Is he a good man?

Wilson: He's a good... doctor.

Rebecca: Can you be one without the other? Don't you have to care about people?

Wilson: Caring's a good motivator. He's found something else. (He continues examining her) Feel this? Both sides?

Rebecca: Uh-hm. (nods)

Wilson: 'Kay. Squeeze. Harder. Alright.

Rebecca: He's your friend, huh?

Wilson: Yeah.

Rebecca: Does he care about you?

Wilson: I think so.

Rebecca: You don't know?

Wilson: As Dr. House likes to say, everybody lies.

Rebecca: It's not what people say. It's what they do.

Wilson: (hesitates) Yeah. He cares about me.

(Wilson goes to leave)

Rebecca: I can't see... I can't see... (Rebecca throws her head back and starts seizing. It kind of looked like something from The Exorcist actually. Wilson rushes over to her and tries to hold her down. Rebecca's heart rate is extremely rapid.)

Wilson: A little help in here!

(Rebecca's heart monitor goes crazy and then goes totally flat-line.)

(Panning shot of hospital, it's now morning.)

(We're still in Rebecca's room. She's got an oxygen mask on.)

Foreman: You're chest will be sore for a while. We needed to shock you to get your heart going. Mmmkay. (puts a couple cards on the table in front of her) Can you arrange these to tell a story? (She just stares at them.)

(We're now in House's office with the whole team gathered inside.)

Foreman: She couldn't put them in order.

Chase: Could the damage have been caused by lack of oxygen during the seizure?

Foreman: No, I gave her the same test five minutes later. She did just fine. The altered mental status is intermittent, just like the verbal skills.

Cameron: So, what now?

Foreman: Given the latest symptoms, it's clearly going deeper into the brain stem. Soon, she won't be able to walk. She'll go blind permanently and then the respirtory center will fail.

House: How long do we have?

Foreman: If it's a tumor, we're talking a month or two. If it's infectious, a few weeks. If it's vascular, that'll probably be fastest of all, maybe a week.

House: We're gonna stop all treatment. (House walks out of room and the ducklings follow him)

Foreman: I still think it's a tumor. I think we should go back to the radiation.

Chase: She didn't respond to the radition.

Foreman: Maybe we didn't see the affect until we started her on steroids.

House: Nope. It's not a tumor. Steroids did something. I just don't know what.

Foreman: So, we're just gonna do nothing? We're just gonna watch her die.

House: Yeah. We're gonna watch her die. Specifically, we're gonna watch how fast she's dying. You just told us- each diagnosis has its own time frame. If we see how fast it's killing her, we'll know what it is.

Cameron: And by then maybe there's nothing we can do about it.

Foreman: There's gotta be something we can do. Something better than watch her die.

House: Well, I got nothing. How 'bout you? (everybody looks at Foreman)

(Foreman and Cameron walk out of House's office)

Foreman: Bastard. Oh, Cameron. I need you for a couple of hours.

Cameron: What's up?

Foreman: When you break into someone's house, it's better to have a white chick with you.

Cameron: Adler's house? Why don't we just ask her for her keys?

Foreman: For all we know, she could be running a meth lab out of her basement.

(Back to House in the clinic exam room, this time with a middle-aged man. House is looking particularly bored.)

Clinic Patient: I'm tired a lot.

House: Any other reason why you think you might have Chronic Fatigue Syndrome?

Clinic Patient: It's kinda the definition, isn't it?

House: It's kinda the definition of getting older.

Clinic Patient: I had a couple headaches last month. Mild fever. Sometimes I can't sleep and I have trouble concentrating.

House: Apparently not while researching this stuff on the Internet.

Clinic Patient: I was thinking it might also be fibromyalgia.

House: Excellent diagnosis!

Clinic Patient: Is there anything... for that?

House: (gets a thoughtful expression on his face and suddenly "gets an idea") D'you know, I think there just might be. (leaves the exam room and goes to the pharmacy counter and asks the pharmacist for...) Thirty-six Vicodin and change for a dollar. (He puts a dollar bill on the counter and gets the quarters. He goes over to a candy machine and gets a handful of mints. He goes back to the counter, empties the Vicodin bottle into his pocket and puts the mints inside the empty bottle and puts it back on the counter.) Exam room two.

(We see Cameron peering into a cupboard in Rebecca's house.)

Cameron: House doesn't believe in pretense. He figures life's too short and too painful. So, he just says what he thinks.

Foreman: (looking in the trash) Nothing interesting in the garbage. 'I say what I think' is just another way of saying 'I'm an ass'.

Cameron: (looking under sink) Well, if you wanted to be judged for your medical prowess only, maybe you shouldn't have broken into someone's home.

Foreman: (looking in dog's bed) I was sixteen! Don't know 'bout ticks but her dog's definitely got fleas.

Cameron: (up in attic) I managed to make it to seventeen without a criminal record.

Foreman: (looking in fridge) Yeah? Well, you, obviously, didn't grow up in my neighborhood. (he removes some ham slices from her fridge and some mayo- I think it was mayo)

Cameron: (walking into kitchen to join Foreman) That's right, you stole a loaf of bread to feed your starving family, right? (Foreman smells the ham slices.) Do you always eat during break-ins?

Foreman: Am I supposed to respect their food more than I respect their DVD players? (Cameron removes a drawing done by one of Rebecca's students.) You want some?

Cameron: No.

Foreman: You gonna go hungry until she dies?

Cameron: No.

Foreman: (while making a sandwich) You know what, after centuries of slavery, decades of civil rights marches and more significantly, living like a monk, never getting less than a 4.0 GPA, you don't think it's kind of disgusting that I get one of the top jobs in the country because I'm a deliquant? (Cameron removes her glasses) We'll eat and then we'll tear up the carpet.

Cameron: (sits down) You went to Hopkins, right?

Foreman: Yup.

Cameron: So, you want to a better school than I did. You got better grades than I did.

Foreman: (laughs) So how did you get the job? You stab a guy in a bar fight? (Cameron looks troubled and confused.)

(Shot of people going up the stairs in front of the hospital and then to House's office.)

Foreman: Nothing.

House: It's not a tumor. She's getting worse too fast. Can't stand up.

Wilson: No toxins? No medications?

Foreman: Nothing that would explain these symptoms.

Wilson: Family history of neurological problems?

Foreman: Not that I could tell from her underwear drawer. (Wilson smirks.)

House: You said nothing that would explain these symptoms. What did you find that doesn't explain these symptoms?

Foreman: Dr. Wilson convinced you to treat this patient under false pretenses. Adler's not his cousin.

Wilson: That's ridiculous. You can ask her yourself. Why- Can we get back-

Foreman: She's not Jewish.

Wilson: Rachel Adler's not Jewish.

Foreman: I had ham at her apartment.

Wilson: (laughs awkwardly) Dr. Foreman, a lot of Jews have non-Jewish relatives and most of us don't keep kosher. (House gets pensive again- the wheels are turning once more.) I can see getting through high school without learning a thing about Jews but medical school...

Foreman: Maybe she's Jewish but she's definitely not your cousin.

Wilson: Really. This guy's-

Foreman: You don't even know her name! You called her Rachel, her name is Rebecca!

Wilson: Yes, yes. Her name is Rebecca, I call her Rachel. (Wilson knows he's messed up.)

House: (shouts) You idiot!

Wilson: Listen, he's-

House: Not you! (gestures to Foreman) Him. You said you didn't find anything.

Foreman: Everything I found was-

House: You found ham.

Foreman: So?

House: Where there is ham, there's pork. Where there's pork, there's neurocysticercosis.

Chase: Tape worm? You think she's got a worm in her brain?

House: It fits! Coulda been there for years. Never occur to me that-

Cameron: Millions of people eat ham everyday. It's quite a leap to think that she's got a tape worm.

House: Okay Mister Neurologist. What happens when you give steroids to a person who has a tape worm?

Foreman: They get a little better and... and then they get worse.

Wilson: Just like Rebecca Adler did.

(Shot of the door on House's office- the one that says "Gregory House, M.D.: Department of Diagnostic Medicine". Inside, House puts a medical textbook down, open to a page that shows a number of different types of tape worms- presumably)

House: In a typical case, you don't cook pork well enough, you digest live tapeworm larvae. (a CGI clip shows the larvae inside the body) They got these little hooks, they grab onto your bowel, they live, they grow up and reproduce.

Chase: Reproduce? There's only one lesion and it's nowhere near her bowel.

House: Yeah. That's because this is not a typical case. Tapeworms can reproduce twenty to thirty thousand eggs a day. Guess where they go.

Foreman: Out.

House: (another cool CGI clip, this time featuring a tapeworm egg) Not all of them. Unlike the larvae, the egg can pass right through the walls of the intestines, into the blood stream. Where does the blood stream go?

Cameron: Everywhere.

House: As long as it's healthy, the immune system doesn't even know it's there. The worm builds a wall, uses its secretions to shut down the body's immune response and control fluid flow. It's really quite beautiful.

Foreman: As long as it's healthy. So, what d'we do? Call a vet? Nurse the little guy back to health.

House: It's too late for that. It's dying. (yet another CGI clip, this time taking place in the brain) As the parasite loses the ability to control the host's defenses, the immune system wakes up and attacks the worm and everything starts to swell and that is very bad for the brain.

Wilson: (coming in) It could still be a hundred other things. The eosinophil count was normal.

Chase: It's only abnormal in thirty percent of cases.

Wilson: Proving nothing.

House: Oh, no, no, no! Ya see, it fits! It was perfect. It explains everything.

Wilson: But it proves nothing.

House: I can prove it by treating it.

Wilson: No, you can't... I was just with her. She doesn't want anymore treatments, she doesn't want anymore experiments. She wants to go home and die.

(We see Rebecca sitting up in her bed, still in her hospital room. It's raining outside and it's dark. House enters the room.)

House: (to nurse) Would you excuse us please? (He stands at the end of her bed and she stares at him dully.) I'm Dr. House.

Rebecca: S'good to meet you.

House: You're being an idiot. (clears his throat; Rebecca just looks out the window) You have a tapeworm in your brain. S'not pleasant but if we don't do anything you'll be dead by the weekend.

Rebecca: Have you actually seen the worm?

House: When you're all better, I'll show you my diplomas.

Rebecca: You were sure I had vasculitus too. Now I can't walk and I'm wearing a diaper. What's this treatment gonna do for me?

House: I'm not talking about a treatment, I'm talking about a cure. But because I might be wrong, you wanna die.

Rebecca: What made you a cripple?

House: I had an infarction.

Rebecca: A heart attack?

House: It's what happens when the blood flow is obstructed. If it's in the heart, it's a heart attack. If it's in the lungs, it's a pulmonary embolism. If it's in brain, it's a stroke. I had it in my thigh muscles.

Rebecca: Wasn't there something they could do?

House: There was plenty they could do, if they'd made the right diagnosis. The only symptom was pain. Not many people get to experience muscle death.

Rebecca: Did you think you were dying?

House: I hoped I was dying.

Rebecca: So you hide in your office, refuse to see patients because you don't like the way people look at you. You feel cheated by life so now you're gonna get even with the world. You want me to fight this. Why? What makes you think I'm so much better than you?

House: When you're scared, you'll turn into me.

Rebecca: I just wanna die with a little dignity.

House: (sternly) There's no such thing. Our bodies break down, sometimes when we're ninety, sometimes before we're even born but it always happens and there's never any dignity in it. I don't care if you can walk, see, wipe your own ass. It's always ugly, always. (Rebecca's eyes are full of tears and House softens his tone.) We can live with dignity. You can't die with it. (A tear rolls down Rebecca's cheek.)

(The next thing we see is House walking down the hall to meet his team.)

House: No treatment.

Foreman: Maybe we can get a court order, override her wishes, claim she doesn't have the capacity to make this decision.

House: But she does.

Cameron: But we could claim that the illness made her mentally incompetant, right?

Foreman: A pretty common result.

House: That didn't happen here.

Wilson: He's not gonna do it. She's not just a file to him anymore. He respects her.

Cameron: So because you respect her, you're going to let her die.

House: I solved the case. My work is done. (walks away) Patients always want proof. We're not making cars here, we don't give guarantees.

Chase: I think we can prove it's a worm. (House turns around at the end of the hall) It's non-invasive, it's safe. (walks toward House) I'm not completely sure but I thought of it-

House: Yeah, yeah, yeah. What's the damn idea?

Chase: Have you ever seen a worm under an X-ray? A regular, no-contrast hundred-year-old technology X-ray- they light up like shotgun pellets, just like on a contrast MRI.

Foreman: Which is the same thing as a CT scan which we did, which proved nothing.

House: Worms cysts is the same density as the cerebrospinal fluid. We're not gonna see anything in her head. But Chase is right. He's right, we should X-ray her. But we don't X-ray her brain, we X-ray her leg. Worms love thigh muscle. If she's got one in her head, I guarantee you there's one in her leg.

(Rebecca is laying on the X-ray table with the team outside looking in.)

Chase: Hold still, Rebecca.

(The machine goes THUD and a CGI clip shows inside the leg where, sure enough, a tapeworm is squirming around in his little wormy way.)

(We're back in Rebecca's room and she's back in bed.)

Chase: (Chase points to the X-ray) This here, is a worm larvae.

Rebecca: So if it's in my leg, it's in my brain.

Chase: Are you looking for a guarantee? (Rebecca shakes her head) It's there. Probably been there for six to ten years.

Rebecca: Do I have more?

Chase: Probably. (Rebecca stares at him.) It's good news.

Rebecca: What do we do now?

Chase: Now we get you better. Albendazole. (hands her a cup with pills in it)

Rebecca: (shakes her head) Two pills.

Chase: Yeah. Every day for eat least a month with a meal.

Rebecca: Two pills.

Chase: Yeah. Possible side effects include abdominal pain, nausea, headaches, dizziness, fever and hair loss. We'll probably keep making you take the pills even if you get every one of those.

(Rebecca takes the pills.)

(We see House walking down the hall and into his office where he finds Cameron sitting- in his chair, to be exact.)

Cameron: Why did you hire me?

House: Does it matter?

Cameron: Kinda hard to work for a guy who doesn't respect you.

House: Why?

Cameron: Is that rhetorical?

House: No, it just seems that way 'cause you can't think of an answer. (Cameron gets up and follows him to the other room) Make a difference what I think? I'm a jerk. The only thing that matters is what you think. Can you do the job?

Cameron: You hired a black guy because he had a juvenile record.

House: (makes himself a coffee) No, it wasn't a racial thing. I didn't see a black guy, I just saw a doctor... with a juvenile record. I hired Chase because his dad made a phone call. I hired you... because you're extremely pretty. (walks away, back into his office)

Cameron: You hired me to get into my pants?

House: I can't believe that that would shock you. It's also not what I said. (looks her up and down) I hired you 'cause... y'look good. It's like having a nice piece of art in the lobby.

Cameron: I was in the top of my class.

House: But not the top.

Cameron: I did an internship at the Mayo Clinic. (House sits down at his desk)

House: You were a very good applicant.

Cameron: But not the best.

House: Would that upset you? Really? To think that you were hired because of some genetic gift of beauty instead of a genetic gift of intelligence?

Cameron: (looks deadly serious) I worked very hard to get where I am.

House: But you didn't have to. People choose the paths that gain them the greatest rewards for the least amount of effort. That's the law of nature. And you defied it. That's why I hired you. You could've married rich, coulda been a model, you could've just shown up and people would've given you stuff- lots of stuff. But you didn't. You worked your stunning little ass off.

Cameron: Am I supposed to be flattered?

House: Gorgeous women do not go to medical school. Unless they are as damaged as they are beautiful. (tilts his head, thinking) Were you abused by a family member?

Cameron: No!

House: Sexually assaulted?

Cameron: No!

House: But you are damaged, aren't you?

Cameron: (while she's just starting at him, her pager goes off) I have to go.

(We now see Orange Man and Cuddy talking in her office.)

Orange Man: I followed her.

Cuddy: Oh...

Orange Man: I couldn't stop thinking about what that doctor said.

Cuddy: I told you not to listen to him, he's an idiot.

Orange Man: I was orange!

Cuddy: I don't wanna know what you found out.

Orange Man: You don't care?

Cuddy: I'm your doctor. You've been good to me and good to this hospital, of course I care. But I don't see how this conversation can end well for me. Either your wife is having an affair or she's not having an affair and you've come here because you rightly think I should fire him. But I can't... even if it costs me your money. The son of a bitch is the best doctor we have.

(it shows his hand where this is a tan line where his wedding band used to be so, obviously, House was right about the affair.)

(Chase and Cameron enter Rebecca's room.)

Chase: Feeling any better?

Rebecca: I can't complain. As you know, the hospital has certain rules and as you also know we tend to ignore them. But I think this one is gonna be a little obvious unless we get your help.

Cameron: If anyone asks, you have eleven daughters and five sons. (Rebecca's kindergarten class enters the room and Rebecca welcomes them with open arms.)

Rebecca: It's so good to see you guys, I missed you! (one of the children open a big card that says "We Miss You" on the front and "We're happy you're not dead Miss Rebecca" on the inside.) I love you guys. (to Cameron and Chase) I wanted to thank Dr. House but he never visited again.

Cameron: He cured you, you didn't cure him.

Rebecca: (back to her students) Okay, I want a hug and a kiss from every single one of you! Get up here right now!

(House is in the clinic exam room, watching a General Hospital on his mini-TV. Wilson is sitting off to the side, reading a newspaper.)

House: You said she was your cousin. Why would you lie?

Wilson: It got you to take the case.

House: You lied to a friend to save a stranger, you don't think that's sorta screwed-up.

Wilson: You've never lied to me?

House: I never lie.

Wilson: Oh, right.

Male Doctor on TV: Why do we do this?

Female Doctor on TV: Because we're doctors. If we make mistakes, people die. (oddly enough, this is the same line Cuddy uses earlier in the show)

(A nurse comes in.)

Nurse: Dr. House? You have a patient. (She opens the blinds so House can see who it is. It's the patient from earlier that House gave the candy to.) He says he needs a refill.

House: (grins at Wilson) Got change for a dollar?

(Another lovely shot of the hospital with a chorus version of "You Can't Always Get What You Want" playing)

THE END