Season 1 X 07 : Fidelity

Original Airdate: 12/28/2004
Written by: Thomas L. Moran
Directed by: Bryan Spicer
Transcript by: Celebmir

BEGINNING

[Ed and his friend are jogging in the park]

Friend: So now the plan is either find ourselves a new counselor, stick it out with the old one but go more often, or resign ourselves to the fact that she's never gonna be happy no matter what I do, so let's just take the money we're wasting and put it towards a membership at Lakeview, you know?

Ed: I’m guessing the last option has [???] you present it?

Friend: Yeah… Jeez what’s with you? It usually takes about half speed to stay with me.

Ed: I didn't get a lot of sleep last night.

Friend: How are things with Elise?

Ed: Great.

Friend: Great?

Ed: Yeah.

Friend: Simple answers. You’re either out of breath or you're lying to me.

Ed: Yeah… we have our moments, but they usually work out. Can I get some water?

Friend: Yeah… How do you work things out?

Ed: Talk, someone apologizes. Man I shouldn't have drank last night.

Friend: You mean you apologize.

Ed: Yeah, I guess.

Friend: How often do you guys have sex?

Ed: Enough…

Friend: You do it this morning? [Ed smirks, goes to shake his head] You did, you did it this morning, maybe that’s why you can’t stand up. Come on!

[Ed and Elise’s house]

Ed: Elise! Honey, I’m dehydrated. [opens fridge] We have anything with electrolytes? [In the bedroom] Sleeping beauty, wake up, this is an emergency. The fridge is empty. Come on, it’s almost four! Elise, sweetie…

Elise: Call Jacques, tell him I’m not feeling well.

Ed: It’s Saturday. You haven’t been to work in three days, remember?

Elise: Just let me sleep.

Ed: Come on. You haven’t been out of bed since Wednesday.

Elise: Leave me alone…

Ed: Come on, lets go.

Elise: No, leave me alone.

Ed: Honey-

Elise: [smacks him, hard] I SAID LEVE ME ALONE!!!! [comes back to herself] I think there’s something wrong with me.

[PPTH Lobby]

Cameron: She’s been averaging 18 hours of sleep a day since her admission.

House: Clinical depression. Incredibly contagious. Every time I’m around one of them I get blue.

Cameron: It’s not clinical depression.

House: Great, you got it all figured out. You don’t need me.

Cameron: Three ER doctors, two neurologists and a radiologist have all figured out what its not, we need to figure out what it IS.

House: Well maybe if above mentioned doctors were interested in my opinion they would have asked for it.

Cameron: None of them are willing to subject themselves to you.

House: No pain no gain. [gets in the elevator]

Cameron: The blood work showed no signs of inflammation, and no one can figure out what’s actually the cause of--

House: Huh.

Cameron: What?

House: Husband described her as being unusually irritable recently.

Cameron: And?

House: I didn't know it was possible for a woman to be "unusually" irritable. [elevator dings, they get off]

Cameron: Nice try, but you’re a misanthrope, not a masochist.

House: What’s the first thing you ask a doctor who’s referring a patient?

Cameron: Are you questioning my ability to take a history? [House just looks at her] “What’s the primary”-

House: Not “what?”. “Why?”

Cameron: Diseases don’t have motives.

House: No, but doctors do. Why this patient, what interests you? Give me the chart.

Cameron: Why?

House: I find your interest interesting.

[Office]

House: She’s irritable, sleeping 18 hours a day.

Foreman: What’s interesting about that? Hypersomnia is usually accompanied by irritability in depressed patients.

House: True, but not relevant. She’s not depressed.

Foreman: Hello! She’s sleeping 18 hours a day!

House: Fever. Clinical depression does not cause fever.

Foreman: She could be sick and depressed?

House: She’s sick! Dammit, why didn’t I think of that?

Foreman: That’s what I mean…

Cameron: Elevated SED rate indicates inflammation.

Foreman: Hypersomnia and personality changes point toward the brain.

House: Not the spleen. Thank goodness we hired a neurologist! Brain symptoms… hmm, could this be a brain problem?

Cameron: No other systemic signs of inflammation, probably not vasculitis.

Chase: What about parasites? Malaria, chagas?

Cameron: Patient’s never been outside the United States, especially the tropics.

Chase: You mean she claims she’s never been outside the U.S.

House: Very good.

Cameron: Doesn’t matter, blood and c-sub smears show no sign of parasites.

House: Has to be a tumor then.

Foreman: A tumor sitting directly on top of the brain stem? That three ER doctors, two neurologists, and a radiologist missed?

House: Partridge in a pear tree missed it too. Redo the blood work and get a new MRI with 2 millimeter cuts through the [some complex brain term, sound like “mesodinasipellic”???]. [leaves the office, calls out as he leaves] And check for evil stepmothers. This much sleep usually indicates poisoned apples.

[Exam Room 1]

House: Anything else beside the shortness of breath?

Mrs. Campbell: Not really, its actually just kind of a tightness.

House: You smoke?

Mrs. Campbell: No, never.

House: Exercise?

Mrs. Campbell: Eight hours a day. [House looks amazed] I teach preschool.

House: Sounds fun. Any history of heart disease in your family?

Mrs. Campbell: Not that I know of.

House: [pulls out a stethoscope] Take a deep breath. Been under a lot of stress lately?

Mrs. Campbell: None more than usual.

House: You’re probably just a little anemic, but I’m going to do an EKG just to make sure.

Mrs. Campbell: [indicating her hospital gown] Do I need to take this off?

House: No, you can just pull that down in front. [she does so. He turns around to see that she is very well-endowed] Good. Lord. Are those real?

Mrs. Campbell: Do they look real?

House: They look… pretty damn good.

Mrs. Campbell: They were a present for my husband’s 40th . I figured he'd enjoy them more than a sweater.

House: That's so sweet. I’m afraid the cause of your problem could be staring us right in the face. Actually I guess I’m the one doing the staring. Of course I can’t be sure, I’d like to consult a colleague. He’s actually somewhat of an expert in these matters. [picks up the phone] Can I get a page on Dr. Wilson?

[Elise’s Room]

Ed: A tumor?

Foreman: We don’t know, we’re checking just to be safe.

Ed: They already checked for that.

Foreman: The previous MRI had a broader view.

Cameron: Some tumors are almost impossible to see unless we know exactly where to look.

Elise: That means it would be small, right?

Cameron: Yes.

Ed: So you'd be able to operate? Take it out?

Foreman: If it is a tumor, there are a variety of treatment options, but there are variables other than just size.

Ed: [to Elise] Don’t worry…

Elise: Too late.

[MRI]

Cameron: Try to remain as still as possible. The less distortion there is, the more we'll be able to see.

[coming out of exam room 1]

Wilson: Well. That’s what breasts look like.

House: Is a lie a lie if everybody knows it’s a lie?

Wilson: Well, if a tree pretends to fall in a forest… House, come on, they're breasts. They're a birthday present, not a philosophical treatise.

House: Lie number one, she did not do that for her husband, she did that for herself. She thinks if she looks different, she'll be different.

Wilson: No, she thinks if she looks different, she'll be more attractive, which, I have to say…

House: Not to her husband. Cosmetic surgery is so that everyone else will look at us differently. Same reason you're wearing that tie.

Wilson: Well exactly, that was going to be my next point.

House: Last three months, same five ties. Thursday should be that paisley thing.

Wilson: It's a gift from my wife.

House: No its not. Julie hates green. You bought that yourself. You want to look pretty. At work. [singsong] Wilson's got a girlfriend…

Wilson: Stop! Stop. I don’t.

Cuddy: It takes TWO department heads to treat shortness of breath? What, do the complications increase exponentially with cup size?

House: I want an EKG and blood tests including tox screen on Mrs.… Exam Room 1.

Cuddy: You're ordering tests to cover your lechery. Interesting.

House: Very tricky case. [to Wilson] You love everybody. That’s your pathology.

[Elise’s Room]

Foreman: There were no lesions and no mass effect that we could see.

Elise: What does that mean?

Foreman: It means we’re still not sure what’s causing your neurological problems.

Ed: I know some thing are hard to cure, but what I just don’t get is why it’s taking so long to figure out what’s wrong with her.

Cameron: I know you’re scared, I would be too.

Elise: I don’t feel good…

Foreman: You feeling nauseous?

Ed: Honey? You all right? [cool CGI of a muscle tensing in Elise’s throat]

Cameron: She’s seizing! Get her on her side. I need some Ativan!

Ed: What’s happening?

Cameron: She’s having a seizure.

Foreman: She’s aspirating, suction!

Cameron: Come on Elise!

[In Elise’s room, she is being given some kind of test. She can’t draw circles]

[Office]

Wilson: The MRI reveals nothing.

Foreman: That we were able to detect.

Wilson: It’s not a tumor.

Foreman: A small glioma could hide from contrast. We could do a PET scan.

House: Yes, that’s how a responsible doctor would waste his time in the situation.

Foreman: Suddenly tests and radiologists aren’t capable of error?

House: A glioma not presenting on a contrast MRI would have to be smaller than a grain of sand, which does not a gravely ill person make.

Chase: It could be just postictal disorientation.

Cameron: We would have seen improvement by now.

Chase: Late stage Lyme Disease can cause seizures.

House: Does the husband care about her?

Cameron: He hasn't left her bedside.

House: Now way… it also means she doesn’t have Lyme Disease.

Foreman: What? Love conquers all?

House: Lyme Disease initially presents with a rash. Mr. Clingy would have noticed.

Foreman: We've looked at everything else.

Wilson: Did you look at her breasts?

House: Pff. Men.

Wilson: Could be paraneoplastic.

House: She have any family history of breast cancer?

Cameron: Her mother died of it.

House: [to Foreman] The brain, but not the brain. Clever, huh?

[The hall outside of Elise’s room]

Ed: How can breast cancer cause problems in her brain?

Cameron: There are molecular similarities between brain cells and tumor cells. Paraneoplastic Syndrome causes the body's own antibodies to get thrown off track. They end up attacking the brain instead of the tumor.

Ed: So if you do find the tumor, what do you do?

Foreman: We treat the underlying malignancy. Once there's no tumor to attack, there’s nothing for the antibodies to get confused about.

Ed: If the tumor's treatable.

Foreman: Exactly.

[Some room with a lot of equipment. Elise is getting a mammogram, etc]

Elise: OW!

Cameron: I'm sorry, I know it's uncomfortable. The tighter we go, the better the image will be.

Elise: Least it'll keep me awake.

Cameron: Don't worry, it's almost over.

Elise: I wish people would stop telling me not to worry.

Cameron: I'm sorry.

Elise: My mom was the same age. We've been trying to get pregnant for over a year. I guess we're lucky we didn’t.

Cameron: A lot has changed since your mom died. Don’t worry- don't give up.

[Office]

House: No tumor?

Cameron: The MRI and mammogram only showed a few benign calcifications.

Wilson: It's most likely a small cell tumor, its no surprise we're having trouble finding it. We should do a PET scan. Start with her lungs, and maybe her bones… Sometimes it presents with no tumor at all.

Chase: How can a disease caused by a tumor present if there's no tumor?

Wilson: It happens. Twelve percent of cases.

Chase: And how do you treat it if there's no tumor?

House: You don’t. Those twelve percent have no treatment. They were too busy looking for the tumor, right till they put the patient in the ground.

Foreman: What choice do we have?

House: Treat the symptoms. IV Immunoglobulin

Foreman: So we're just going to ignore the tumor?

House: Eventually it'll get bigger. Then it'll be really easy to find. One of you needs to check out where she works.

Chase: Why?

House: Cause the husband's not sick.

Chase: Meaning?

Wilson: If it's not paraneoplastic and it is a reaction to some kind of toxic, it’s obviously not coming from their home.

House: Foreman, you do it.

[Getting off the elevator]

Foreman: Why are you riding me?

House: It’s what I do… has it gotten worse lately?

Foreman: Yeah. Seems to me.

House: Really. Well that rules out the race thing. Cause you were just as black last week.

[The kitchen where Elise works]

Foreman: How long has Elise worked here?

Jacques: Three years, she’s my best rotisseur.

Foreman: What’s that?

Jacques: The rotisseur prepares the roasted meats and gravies.

Foreman: How do you clean your grill?

Jacques: [something in French] They say elbow grease.

Foreman: Do you use chemical cleaners?

Jacques: Ah, no. Absolutely no, our chefs don't do the cleaning, anyway.

Foreman: What about pesticides? You must spray for roaches and that sort of thing?

Jacques: Nope, my kitchen is clean. No roaches. [Something in French to another guy] I need to get back to work.

Foreman: And the fact that I’m here asking you these questions, it doesn’t worry you?

Jacques: Look at me. I’m here 18 hours a day. That guy practically lives here, he does live here… I use the same detergents for 15 years and everyone is healthy as a horse. Whatever Elise has she didn’t get here. Tell her I hope she feels better, and I had to get a new rotisseur.

[Foreman sees that there is rabbit on a cutting board]

[Elise’s Room]

Elise: Where's Ed?

Cameron: He went down to the gift shop to buy a shirt. I told him I'd stay up here in case you woke up.

Elise: You must have better things to do.

Cameron: I send my laundry out.

Elise: You're not married?

Cameron: [curt] No.

Elise: Waiting for the perfect guy?

Cameron: [smiling now] Let me guess. You’ve already found him.

Elise: He threw my towels out the window.

Cameron: What?

Elise: It’s how we met. Freshman year, he came to a party my roommate and I threw. He spent most of the night on the bathroom floor. He figured I wouldn’t notice vomit on the towels if I didn’t have any towels.

Cameron: I'm assuming he came back the next day to apologize?

Elise: No way. We had to track him down. Conflict resolution has never been one of Ed’s strong points. Nobody’s perfect, right?

Cameron: I guess.

Elise: Oh my neck hurts.

Cameron: [adjusts the pillow] You've been in this bed for a really long time. We're gonna do the same test we did last night, ok? Do you know what day it is?

Elise: [distractedly scratches her arm] My arm itches.

Cameron: Its probably just a mild skin irritation, I’ll get you some hydrocortisone in a minute. Do you know what day it is?

Elise: [still scratching] Tuesday. It really itches.

Cameron: I'm gonna get you that cream right now.

[Elise scratches and stares in horror as BUGS (lots and lots of bugs) burst out of a boil in her arm]

Elise: Oh my God! Get them off! Someone! Get them off of me!

Cameron: Elise calm down… I need some Haldol, 5 milligrams. There's nothing there, Elise. There's nothing there! [Elise continues to scream]

[Shots of Elise being strapped down… Foreman and House are heading for the office]

Foreman: We had to sedate her.

House: You gave sedatives to a patient who’s already sleeping 18 hours a day?

Foreman: It was better than letting her scratch all the skin off her arms.

House: Or supposed to be.

[Office]

Wilson: Creepy-crawlies are consistent with paraneoplastic syndrome.

Cameron: Onset immediately after IVIG isn't.

House: There is a simple explanation. Maybe she really has bugs under her skin.

Chase: Infection?

House: That’s what the worsening of symptoms after immunotherapy would suggest.

Foreman: Blood cultures and the timeline rule out most bacteria.

House: If a patient throws up on your shoes do you clean up "most" of it?

Foreman: The symptoms rule out the rest. Serology rules out viruses, CSS smears rule out parasites.

House: In the final stage of African Trypanosomiasis almost all the parasites are inside the brain. It's possible they wouldn't show on smears.

Foreman: But it's not possible for a patient who's never been to Africa to have African Sleeping Sickness.

House: I'm just saying it fits the symptoms.

Wilson: She could have got it from a transfusion.

House: Or I'm just saying she could have got it from a transfusion.

Cameron: Which she never had.

House: [glares at her] Okay…

Wilson: What about toxins?

Foreman: No, the kitchen she works in is cleaner than some hospitals. But they do serve rabbit. Rabbit Fever fits her symptoms.

Chase: Tularemia initially presents with a rash or ulcer near the infection site.

Foreman: Not if she inhaled it. Chopping the meat with a cleaver could easily aerosolize the bacteria.

Cameron: No, then she'd have respiratory symptoms.

Foreman: Maybe she ignored it, figured she had a cold.

House: We rejected Lyme Disease because the couple would have noticed a rash, but a wet hacking cough is just going to slip right by?

Foreman: Hey, it’s either that or she missed her exit on the turnpike and wound up in Africa.

House: Two lousy ideas. Unfortunately they're better than all the other ideas. Tularemia. Bizarre. Very nice. That’s why I ride you. [goes into his own office, turns on the TV]

Cameron: Did he just turn on the TV?

Wilson: He needs to think.

[In the lab]

Chase: So this should tell us whether or not she’s got rabbit fever?

Cameron: For a diagnosis of Tularemia you need a four-fold increase in serum antibody levels. To measure an increase you need a before, all we have is an after.

Chase: A single titer over 160 would be a big clue.

Foreman: “That’s why I ride you.” What does that mean? Even when I have a good idea it’s because of him?

Chase: [smirks] Actually I think he said your idea was a lousy idea.

Cameron: It has to be one of these two conditions. I say we take our best guess and just start treatment. Or treat both.

Chase: The treatment for Tularemia can cause aplastic anemia.

Foreman: How come he doesn’t ride you guys?

Chase: He's got a crush on you. He just doesn't know how to show it.

Cameron: [smiles] Get over it, he rides everybody.

Chase: And the treatment for sleeping sickness kills one in ten patients.

Cameron: So we start with the safer treatment.

Foreman: By “safer” you mean the one that’s slightly less likely to kill her?

[House’s office, he turns the TV off]

House: Foreman got the gang testing for Tularemia?

Wilson: Yep.

House: Probably inconclusive, but worth doing. So what's her name? When do I get to meet her?

Wilson: There's nobody. Give it up.

House: Your lips say no, your shoes say yes.

Wilson: Well they're French. You can't trust a word they say.

House: Solid, yet stylish. A professional woman would be impressed. I'm thinking accountant, actuary, maybe. It's somebody in the hospital. Patient? No, chemo's not sexy. Daughter of the patient? She would certainly have the neediness you need.

Wilson: I'm not gonna date a patient’s daughter.

House: Very ethical. Of course, most married men would say they don’t date at all.

Wilson: There was no date! [House glares] I had lunch with one of the nurses. It's her first time in an oncology unit and she's having a tough time, emotionally.

House: Perfect.

Wilson: I wanted to be nice. That’s all. I mean it.

House: You always do. It's part of your charm.

Cuddy: [enters] Hi boys. Mrs. Campbell's test results. [they keep their faces blank] Oh, you remember her, the preschool teacher with the heart of silicon.

House: Nope, doesn't ring a bell.

Cuddy: They came in yesterday, I figured you guys would have been all over them. I know how concerned you are.

House: [to Wilson] She's all upset because we paid more attention to the other girl. You check out her ass, I've got the chest.

Cuddy: The tests were normal. Course that's just my opinion, you may want to call a couple of guys from maintenance in for a consult.

House: [to Wilson] You check her EKG results before she left the other day?

Wilson: You ordered it.

House: You're the responsible one.

Cuddy: What’s wrong? They look normal to me.

House: [to Cuddy] Where is she?

Cuddy: Waiting downstairs, why?

House: I was right.

[Exam Room 1]

Mrs. Campbell: Do I have to get rid of the implants?

House: Surprisingly, no. But your EKG shows a slightly decreased heart rate.

Mrs. Campbell: Is that a problem?

House: You told me you hadn’t changed your diet or exercise, were you lying?

Mrs. Campbell: Lying?

House: Does your husband have high blood pressure?

Mrs. Campbell: My husband?

House: Yeah... see, if you’re gonna repeat everything I say this conversation is gonna take twice as long.

Mrs. Campbell: Yes, he was diagnosed six moths ago…

House: He do a lot of cooking at home?

Mrs. Campbell: Not really, other than oatmeal in the morning.

House: Did you happen to notice a slightly odd taste to the oatmeal lately?

Mrs. Campbell: Wait, are you saying that--

House: That it looks like your husband stirred in some of his blood pressure medication along with brown sugar.

Mrs. Campbell: You think my husbands trying to poison me?!

House: No, nothing like that. He just doesn’t want to have sex with you. [Mrs. Campbell looks stunned] Decreased sex drive is one of the most common side effects of the beta blockers he's been taking. I’m guessing he figured if you're both frigid, no harm no foul. You should have gotten him the sweater.

Mrs. Campbell: That’s ridiculous.

House: Fine. But if you’re still concerned about the shortness of breath, I’d start making your own breakfast. [opens the door to leave]

Mrs. Campbell: Wait! What should I do?

House: Well, if you care about your husband at all, I'd do the responsible thing: buy yourself some condoms, go to a bar, find… [seems to realize something] Huh. [leaves]

[The Lab. A paper prints right as House walks in]

House: Lab tests inconclusive?

Cameron: Not surprisingly.

House: No. Too bad. Luckily, I have the answer. [pause]

Chase: To what?

House: Thanks for asking. To life itself. Sex. Anything that can be transmitted via the blood can be transmitted through sex.

Foreman: Sleeping sickness from sex?

House: It’s not without precedent.

Foreman: I'm pretty sure it is. Unless you’re talking about going to Africa and having sex with the tse tse fly.

House: A Portuguese man was diagnosed three years ago with CNS affected sleeping sickness. His only connection with Africa was through a girlfriend who served under the military in Angola.

Chase: Oi, where’d you find that

House: The journal de Instituto de Higina y Medicina Tropical. You don't read Portuguese?

Cameron: You do?

House: I’m pretty sure that’s what it said. Either that or it was an ad for sunglasses.

Cameron: Her husband has never been to Africa either.

House: Ooh, stymied again. Your logic is bulletproof.

Cameron: I think ignoring respiratory symptoms is more likely than cheating.

House: Because?

Cameron: They're completely devoted to each other.

House: Because?

Cameron: They love each other.

House: Or?

Chase: They're overcompensating for guilt.

House: [to Cameron] Find out which it is.

Cameron: You want me to ask a man whose wife is about to die if he cheated on her?

House: No, I want you to be polite and let her die. [Cameron gives him a look] Actually, I don't want you to ask her anything. Foreman take the husband, Chase take the wife.

[The hall right outside the lab]

Cameron: You don't trust me to do my job?

House: We all formulate questions based on the answers we want to hear.

Cameron: And how exactly do you re-formulate "Have you screwed around?"

House: Did you know she’s been trying to get pregnant?

Cameron: Yes.

House: After you got so freaked about the sick babies a while ago I figured that was your thing. But you've never been prescribed folic acid, and you can't lose a baby if you’ve never been pregnant.

Cameron: You pulled my medical records?

House: You coughed the other day, I was concerned.

Cameron: You were curious. Like an eight-year old boy with a puzzle that’s just a little to grown-up for him to figure out. [stalks off]

House: To-MAY-to, to-MAH-to…

[A cool scene alternating from Foreman/Ed in the lobby to Chase/Elise in her room]

Ed: So… it’s either sleeping sickness or this rabbit thing.

Foreman: They’re both fatal without treatment. And unfortunately the treatment for both is extremely dangerous.

Ed: Are there test you can do?

Foreman: Not at this stage. But each condition has a unique history. We're hoping your answers to a few questions will help us.

Ed: Sure. Whatever you need to know.

Chase: Before the sleeping problems, did you have any trouble breathing, a cough that wouldn't go away, anything like that?

Elise: No

Chase: Are you certain?

Ed: Absolutely. I've never been away from her for more than a night, if she had breathing troubles, I would have noticed.

Foreman: [sighs] The other condition is significantly more likely if… if you've had an affair.

Chase: Have you ever had an affair?

Elise: Of course not.

Chase: You sure?

Ed: I think I'd remember cheating on my wife.

Foreman: You might be reluctant to admit it--

Ed: No.

Foreman: I just want to be perfectly clear. If your wife has sleeping sickness and we don't treat her, she'll die.

Elise: I would never do that to Ed. I love him.

Ed: Absolutely not. I love her

[Office. House is packing up his stuff]

House: Alright then. They say no cheating, we cross of sleeping sickness. Any new ideas? Ok, we go with Foreman's Tularemia. Start her on IV-Chloramphenicol 25 milligrams per kilogram four times a day. Good night. [leaves]

[Elise’s Room. Cameron is administering the medicine]

Elise: Where’s Ed?

Cameron: Right next to you. Two down, two to go.

Elise: Two days?

Cameron: No, doses. You have about twenty more days of this fun.

Elise: What time is it?

Cameron: About four a.m. I pulled the short straw. [checks the monitor] Flow rate looks good. No rash or flushing…

Elise: [somewhat incoherent] What time is it?

Cameron: Four a.m. Do you not remember just asking?

Elise: I don’t know…

Cameron: Elise…? Elise? Elise? Elise! [starts gently shaking Elise]

Ed: What are you doing?

Cameron: [shaking a little harder] Trying to wake her.

Ed: She fall asleep again?

Cameron: In the middle of a sentence.

Nurse: What's happening?

Cameron: Patient's not responding. Pulse is fine, airways open. Check her blood pressure. [shines a light in Elise’s eye] Pupils are reactive.

Ed: Elise wake up. You gotta wake up. [Cameron is pinching Elise’s finger] What does that mean? What are you doing?

Cameron: She's not responsive to pain. Come on Elise!

Ed: Is she dying?

Cameron: I don’t know. [looks at the monitor… realizes…] She's in a coma.

[House and the Ducklings are walking down the hall]

House: There's only one way a Tularemia patient goes into a coma while on IV-Chloramphenicol.

Cameron: The patient doesn’t have Tularemia.

House: And then there was one. Patient comes in because she's sleeping too much. It takes ten doctors and a coma to diagnose sleeping sickness.

Foreman: And then there was none. We still have the problem of explaining how a white chick from Jersey who's never traveled south of D.C. has African sleeping sickness.

House: Well, the obvious explanation?

Foreman: I made it clear. If this guy's lying about sleeping around, he knows he's murdering his wife.

House: Does seem unlikely… Go away. [he enters Elise’s room]

House: [lifts Elise's arms, drops them]

Ed: [Appears out of nowhere] What are you doing?

House: Checking for lymphadenopothy. And waiting for you.

Ed: Who are you?

House: I’m Dr. House. Your wife has human African Trypanosomiasis. [Ed looks puzzled] Sleeping sickness.

Ed: You mean its not Tularemia. A virus, tumor or- or cancer.

House: Nope.

Ed: I’ve never had an affair.

House: I believe you.

Ed: And I trust Elise.

House: The treatment for this disease is a drug that’s… fatal on its own ten percent of the time. [Ed looks rather scared] Which is why I need your written consent before I can legally prescribe it.

Ed: Why would she lie if she knew it could kill her?

House: I don’t ask why patients lie, I just assume they all do.

Ed: But why?

House: To protect you, because she didn’t think it mattered. It just seemed easier because… that’s what people do. Now, If you're absolutely certain that your wife has never had sex with anyone but you since you've been married, then I’m wrong. But if you think there’s a possibility that just one time she wasn’t perfect… one weekend you’re out of town… one fight when she ran to a friend, one stupid Christmas party… then you need to allow me to start treatment. Because if we don’t… she’s gonna be dead by tomorrow morning. [Ed thinks it over] Do you trust your wife that much?

Ed: I don’t know… [pause]

House: I’ll start the treatment.

[Elise's Room. Foreman sets down a heavy-looking briefcase and opens it to find three syringes]

Foreman: Glass syringes?

Chase: And special IV tubing.

Foreman: Why do we need this stuff?

Chase: Because Melarsoprol melts plastic. This stuff's supposedly arsenic mixed with antifreeze.

Foreman: What doesn’t kill us makes us stronger, huh?

Chase: At least you wouldn't have been so glib if you'd been prescribed Melarsoprol.

Foreman: [reading a warning tag] “Can cause vomiting, abdominal pain, blood toxicity, neural damage, cardiac arrhythmia…

Chase: Forgot to say it’s gonna hurt like all hell.

Foreman: She’s lucky she’s in a coma. [Chase injects the Melarsoprol. CGI of cells getting “frozen”]

[Later that night]

Ed: How long before we know its working?

Cameron: It’s tough to say. It’s a good sign that she hasn’t gotten any worse.

Ed: Does she even know I'm here?

Cameron: She knows you're always there for her.

Ed: Yeah… if she gets better it means she wasn’t always there for me.

Cameron: It means she made a mistake.

Ed: I can't help it. Part of me, a big part of me… can't handle that. Doesn’t want her to get better. [Cameron heads for the door] Does that make me a terrible person?

Cameron: [hesitant] Yes.

[Elevator dings, Wilson and House step off and make their way down the hall]

Wilson: So we're treating her for African sleeping sickness because you don’t think it’s possible for someone to be faithful in a relationship?

House: And you do?

Wilson: Yes.

House: And you need to tell me that?

Wilson: Look I’m not having an affair. I had lunch, with someone I work with, at work. Once.

House: I believe you. What I don’t believe is that it’ll be just once.

Wilson: I love my wife.

House: You certainly love saying it. [Wilson laughs in a very annoyed way] I’m sorry. I know you love your wife. You loved all your wives. Probably still do. In fact, you probably still love all the women you ever loved who weren’t your wives. [They stop just outside the lab]

Wilson: You can be a real jerk sometimes, you know that?

House: Yeah. And you’re the good guy.

Wilson: At least I try.

House: As long as you’re trying to be good, you can do whatever you want.

Wilson: And as long as you’re not trying, you can say whatever you want.

House: So between us, we can do anything. We can rule the world!

[Wilson sighs and leaves, House sees Cameron in the lab. He enters.]

House: Mixing up some margaritas? Mines a double, Senorita. That’s Portuguese, you know.

Cameron: [quietly, with a hint of tears] Spanish.

House: Uh-oh. What’s going on?

Cameron: I’m re-calibrating the centrifuge.

House: Turn around. [She does, she looks very sad indeed.] It’s a very sad thing, an un-calibrated centrifuge. It makes me cry too.

Cameron: I'm not crying.

House: Ok. [long pause]

Cameron: I told the husband he was a jerk.

House: Why?

Cameron: [hesitates] When I was in college, I… I fell in love, and I got married. And…

House: At that age the chances of a marriage lasting--

Cameron: It lasted six months. Thyroid cancer metastasized to his brain. There was nothing they could do. I was 21, and… I watched my husband die.

House: I'm sorry... But that’s not the whole story. It’s a symptom, not your illness. Thyroid cancer would have been diagnosed at least a year before his death, you knew he was dying when you married him. Must have been when you first met him. And you married him anyway. You can't be that good a person and well adjusted.

Cameron: Why?

House: Because you wind up crying over centrifuges.

Cameron: Or hating people.

[House's pager beeps, he hands it to Cameron. They leave]

Chase: Fever spiked at 104. Echo shows global hyperkinesis.

House: Blood pressure?

Chase: Barely 90 over 40.

House: You give her gilpamine?

Chase: Started 270 micrograms per minute ten minutes ago, still no change.

[They enter Elise's room and look hopefully at Foreman, who is shaking his head]

Chase: Killing her parasites isn't gonna do much good if we kill her heart at the same time.

Cameron: A heart can be replaced, a brain can't.

Chase: Right now were killing both. [To House] If she’s gonna die, we should at least let her do it without that acid flowing through her veins.

Ed: [enters behind them] What’s happening?

House: We would have expected your wife’s condition to show some improvement by now, but it hasn’t. It’s going the other way.

Ed: [takes Elise’s hand] Please don’t die… [stifles a sob] please don’t die… [long pause]

[Elise's heart rate climb, and her hand moves]

Ed: She's awake!

[Ed is talking to Elise in her room. Outside, Cameron looks through the glass window]

Foreman: Hey. She's gonna be ok.

Cameron: Yeah, sure. [Ed leaves the room… with his suitcase. Elise starts to cry. Cameron catches up to Ed] What are you gonna do? Were you always honest with her? Do you know how lucky you are? Your wife is alive, she loves you!

Ed: What she did… you can't love a person and do that to them.

Cameron: She LOVES you.

[Ed leaves]

[House enters Elise's room]

House: I need to know who you had the affair with. He has to be notified so he can get treatment as well. [pause] Why did you lie to us? You knew your life was at stake.

Elise: He's not coming back, is he?

House: We all make mistakes, and we all pay a price. [pause, Elise sniffles] I need that name.

[Cameron goes to a house. There is a little boy sitting outside.]

Cameron: Hi… how you doing?

Little Boy: Fine.

Cameron: Do you know where your dad is?

[Ed's jogging friend comes out of the house]

Friend: Can I help you?

[The camera pans up into a tree.]


END

Season 1 X 06 : The Socratic Method

Original Airdate: 12/21/2004
Written by: John Mankiewicz
Directed by: Peter Medak
Transcript by: Cathy

BEGINNING

[ Lucy and Luke sitting with social worker ]

VOICE: Cat got your tongue? Nah, you killed the cat. Cut off its head.

SOCIAL WORKER: …need to take a look at this.

LUKE: Mom? Mom. Mom! It’s OK.

SOCIAL WORKER: Just a couple of questions before I can authorize extending her disability benefits…

LUCY: I don’t like her. She’s fat.

SOCIAL WORKER: I could lose a little weight.

[ Lucy gasps at sudden pain in leg CGI shot of blood clot in her leg]

LUKE: You all right?

SOCIAL WORKER: Actually, before she signs….

LUCY: I killed the cat, lots of blood.

LUKE: [ to social worker ] It’s OK.

SOCIAL WORKER: I have a couple of questions about some of these dates. The first diagnosis…

LUKE: Schizophrenia. Dr. Walters, May 11th, last year. The letter’s in the medical file.

SOCIAL WORKER: And April 6th? That was the last day she worked, and she received unemployment benefits for that week.

[ view inside Lucy’ bloodstream, a blood clot floating around ]

LUKE: We fixed that, I know we did, we returned the money. [ handing over paper ] That’s the canceled check. Not the real one, you know, it’s a copy.

SOCIAL WORKER: And you’re the dependent?

LUKE: No, that’s my little brother. I’m eighteen. Just helpin’ out.

SOCIAL WORKER: You’re all set. Just need a signature.

VOICE: [ from glass frog on desk ] Hey! I’m talking to you. The cat’s first. Now it’s your turn, Lucy.

LUCY: Shhhhh. Shut up, shut up, shut up!

LUKE: It’s OK, she just, she just needs a little water, is all…

SOCIAL WORKER: I’ll go get it. [ gets up and walks away ]

LUKE: [ taking out a nip bottle of vodka; Lucy swigs at it ] Just hold on, OK, just… when she comes back, sign it and we’re gonna be done. We need this, OK? Please? OK?

LUCY: The voices…

LUKE: The voices aren’t real.

[ Lucy clutches at pain in chest; blood clot gets stuck; she falls to floor ]

LUKE: Mom? Mom! Mom!! Mom!!

[Aerial view of Princeton-Plainview Teaching Hospital ]

ER VOICE-OVER: Thirty-eight year old Caucasian woman, status post-respiratory arrest in the field, intubated, oxygenating poorly.

[ ER waiting room; Luke is pacing ]

P.A.: Dr. Gregory House, please call Dr. Cuddy at extension 3731.

[ House puts down newspaper and frowns up at P.A. from his seat, returns to paper ]

LUKE: [ to House ] This is a good hospital?

HOUSE: Depends what you mean by “good.” I like these chairs. [ back to paper ]

[ Luke sees ER doc and goes over to him ]

LUKE: How is she?

ER DOC: Stable. OK. Your mom had a small pulmonary embolism; blood clot that got stuck in her lungs, blocked the oxygen.

LUKE: [ taking notebook out… ] But the pain started in her leg.

ER DOC: Where the clot started. Her calf. It’s called a deep vein thrombosis. Basically a bigger clot.

LUKE: It never hurt there before. I would have noticed.

ER DOC: Piece of that broke off, went up the vein, through the heart, blocked the blood flow to her lungs. No blood flow, no oxygen.

LUKE: [scribbling] OK…

ER DOC: Is your dad here? I have some things I need to talk to him about.

LUKE: Uh, my dad’s running a little late. [Pauses] He’s dead. Just talk to me – I take care of her.

ER DOC: All right. Your mom’s blood alcohol was .12. Ten thirty in the morning.

LUKE: I gave it to her. Two ounces of vodka. It cools her out. But that’s the first since Monday. That was three days ago. I’ve been real careful. [Doc looks at him; Luke sighs] She hears voices.

ER DOC: She’s schizophrenic? Explains the DVT. The alcohol makes her pass out, she’s immobile for long periods of time…

LUKE: That doesn’t happen. She’s not an alcoholic.

ER DOC: She only drinks when you give it to her. We put her on blood thinners. You can probably take her home tomorrow.

LUKE: It’s not the alcohol, it’s gotta be something else.

HOUSE: [rattling paper] Of COURSE it’s the alcohol. [Both turn to look at him] Hello! [House gets up and walks over to them] This guy’s a professional doctor. Plays golf and everything, I bet. He’s not gonna tell you your mom’s an alcoholic without proof. I’m sure he scoped for varices, checked her esophagus, ran all kinds of blood tests. Doctors like this, they don’t make assumptions, they do the work!

ER DOC: I’d be happy to refer you the case, Dr. House. You seem so interested.

HOUSE: What case? It’s over. You’re sending her home. [ to Luke ] How old is she?

LUKE: You’re a doctor?

HOUSE: Own my own stethoscope. Did I ask you how old she was? I forget.

[ House’s office, House at the whiteboard with marker and Luke’s notes, ducklings sitting around the table ]

HOUSE: Thirty eight year old woman with no previous symptoms or history presents with deep vein thrombosis -- how did she get it?

FOREMAN: Oral contraceptives, smoking, diabetes, obesity, and what’s the point here? A DVT’s a DVT. Put her on IV heparin to prevent future clots. What’s the big mystery?

HOUSE: Fine. You’re all sleeping. You need a clue. [ circles “38yo” on whiteboard ] She’s 38 years old! She’s 20 years too young to get a deep vein thrombosis!

FOREMAN: I treated a 12 year old girl once, soccer player, she got kicked in the leg…

HOUSE: There was no trauma, none of the risk factors.

CAMERON: You took a history?

HOUSE: I… have some notes. They’re not mine, but they’re reliable, I think, for purposes of this discussion. As for the immobility, well, she’s real active right now, of course – paranoia keeps her limber.

FOREMAN: Paranoia?

HOUSE: Oh yeah – she’s schizophrenic. And her kid wrote this [ hefting notebook ], so it might be a little biased. Having to take care of his nutso mom and all. You think there’s a connection? Do we include schizophrenia in the differential for DVT?

FOREMAN: Well…

HOUSE: The answer is no. Abnormal dopaminergic pathways in the brain do not cause blood clots. Schizophrenia is not the cause of DVT.

[ House and Wilson entering Cuyler Wing ]

HOUSE: On the other hand, we don’t really know anything about schizophrenia, so maybe it is connected.

WILSON: Well, the schizophrenia explains one mystery – why you’re so fascinated by a woman with a bump in her leg. Like Picasso deciding to whitewash a fence.

HOUSE: Thanks. I’m more of a Leroy Neiman man. And it is only about the DVT. She’s 38 years old, she should be…

WILSON: Right. Solve this one and you’re on your way to Stockholm. [ they reach the nurse’s station, where Wilson fiddles with paperwork ]

HOUSE: We don’t even know how to treat it! Come on! Fumigation of the vagina?

WILSON: A little louder -- I don’t think everyone heard you. [ walking down the hall ]

HOUSE: Two thousand years ago, that’s how Galen treated schizophrenics – the Marcus Welby of ancient Greece.

WILSON: Oh! Clearly you’re not interested.

HOUSE: I’m interested. I’m interested in how voices in the head could be caused by malposition of the uterus.

WILSON: There’s a better place for it?

HOUSE: And now what have we got? We’ve got lobotomies, rubber rooms, electric shock – my – Galen was so primitive.

WILSON: [ stopping while House walks ahead ] Where are you going?

HOUSE: Going to see the patient. That all-important human connection. Thought I’d give it a whirl.

WILSON: You won’t talk to patients because they lie, but give you patient with no concept of reality… [ catches up ]

HOUSE: If it wasn’t for Socrates, that raving untreated schizophrenic, we wouldn’t have the Socratic method – the best way of teaching everything, apart from juggling chainsaws. Without Isaac Newton, we’d be floating on the ceiling.

WILSON: Dodging chainsaws, no doubt.

HOUSE: And that guitar player in that English band – he was great. [ stopping at Lucy’s room ] You think I’m interested because of the schizophrenia.

WILSON: Yeah. I’m pretty sure.

HOUSE: Galen was pretty sure about the fumigation thing. [ sliding door open and closed ] Pink Floyd.

[ inside Lucy’s room ]

LUKE: Mom, this is Dr…

HOUSE: Gregory House – nice to meet you. [ to Luke ] Be all right if we spoke alone for awhile?

LUKE: Well, you’re gonna need me to…

HOUSE: [ hefting notes ] Got your case notes… doctor. There’s a cafeteria downstairs. [ holding out bill ] Get yourself whatever you want as long as there’s enough left over for a reuben sandwich, dry, no fries, hold the pickles. Should run you about $5.80 with tax. [ Luke takes money; House pulls pager off his belt and hands it to the kid ] I’ll page you when we’re done. [ Luke leaves; House goes over and sits at Lucy’s bedside ]

LUCY: [ shaking head ] No… pickles.

HOUSE: Nice kid. How much do you really drink?

[ she looks at him ]

[ outside Lucy’s room ]

FOREMAN: He’s really talking to a patient?

CHASE: I don’t know who I am anymore.

FOREMAN: It’s a blood clot. What’s so fascinating about that?

CHASE: He likes crazy people. Likes the way they think.

FOREMAN: They think… badly. That’s the definition of crazy. Why would he like…

CHASE: They’re not boring. He likes that.

[Back in the room]

HOUSE: And the meds…

LUCY: [ twitching ] Baseball! I like baseball.

HOUSE: Very nice.

LUCY: Very sad. My boy and me – we went to see a game.

HOUSE: Not “Mets” – meds – medicine. You take what he tells you to take.

LUCY: No one believes me.

HOUSE: I do.

[Outside the room]

FOREMAN: I thought he liked rationality.

WILSON: He likes puzzles.

FOREMAN: Patients are puzzles?

WILSON: You don’t think so?

FOREMAN: I think they’re people.

WILSON: Yeah. Well, he hates them, and he’s fascinated by them. Tell me you can’t relate to that symptom. [ walks away ]

[ Lucy is laughing and smoothing out the blankets over her legs ]

HOUSE: You told Luke it never hurt before.

LUCY: Just rough – they didn’t hurt.

HOUSE: Didn’t?

LUCY: Don’t lie to him, Limpie. Lively Lucy never lies to Lucas. Look what I do to him.

[ House joins other docs ]

WILSON: Learn anything from the “human connection”?

HOUSE: Yeah. The Mets suck. Also, for the last two months, she hasn’t shaved her legs. Because of the tremors… she cuts herself.

CHASE: The tremors aren’t new – she must always cut herself.

HOUSE: Exactly. Something changed in the last two months. I’m thinking the amount of blood when she cut herself. So let’s start with some bloodwork. Collect and send for clotting studies, PT, PTT, factor 5, protein, CNS, the whole shebang.

WILSON: [ walking away ] Good luck.

LUKE: [ coming up to them, sandwich in hand ] No pickles, and it’s cold now.

CAMERON: If it’s a reuben, that’s the way he likes it.

HOUSE: Everyone, this is Luke.

CAMERON: [ standing up to shake hands ] Allison Cameron, it’s nice to…

HOUSE: Yeah, yeah, yeah, save it, we’re busy. Luke, give us another half hour with your mom. We need to do some tests. [ Luke walks away ] Nice kid. Take her off the psych meds, that way we’ll know what’s what on the physical side, and who knows, we might get more out of her. [ guys walk away, House is opening up the wrapper, munching into the sandwich; Cameron is hanging back with him ] Don’t worry – no pickles.

CAMERON: Happy birthday.

HOUSE: [ chewing ] OK… whose?

CAMERON: I was going through your mail, and it was on a form. Happy birthday.

HOUSE: Oh.

[ Cameron walks away; House is still taken aback ]

[ Lucy’s room – Foreman is setting up to draw blood, and Lucy’s not happy ]

LUCY: No, no blood, not mine!

FOREMAN: For the test, Dr. House said… [ Lucy spits in his face; one aide presses call button for help ]

LUCY: You’re gonna steal it, sell it, no, no blood, no, no blood, no, no blood, no! [ nurses and aides come in to hold thrashing patient ]

FOREMAN: Haldol, 5 milligrams, stat.

LUCY: No no no no no no …!

[ she fades out as the Haldol kicks in ]

[ clinic exam room; shot on matching bracelets]

HOUSE: [ entering exam room ] Well, good news, the lab says it’s not strep, so we’re done.

MOM: Wait a second…

HOUSE: No, really, not strep. Boys in the lab, sure, they’re hard drinkers, but they’re pros, you know. Plus, your kid actually has none of the symptoms of strep, I just figured it was quicker running the test than arguing with you. My point is – go!

MOM: I just wanted to ask your opinion, doctor. She’s having a birthday party next week and she’s upset that I’m getting a sugarless cake.

DAUGHTER: The other kids hate it!

HOUSE: This is why you’re here.

MOM: Sugar is the leading cause of obesity in America.

HOUSE: You want a doctor to scare her about the dangers of sugar.

MOM: She needs to get her weight under control.

HOUSE: [ closes door ] Well, you know… [ comes over to girl ] I feel sorry for those other kids, Wendy, who don’t have a mom like yours – a mom who knows that sugar causes heart disease, appendicitis, and athlete’s foot.

MOM: That’s not fair.

HOUSE: Oh, yes it is. No, I get it. You want her to slim down a little, so she can wear pretty clothes like yours. Love the bracelets. Hey! What about matching outfits? You could be twins! She can’t be your daughter, it’s impossible, you look way too young! [ leaving ] Happy birthday. Get the kid a damned ice cream cake.

[ Luke waiting in hall for House ]

LUKE: You drugged her.

HOUSE: Actually, I didn’t. I’ve taken her off all medications.

LUKE: Your guy, Foreman, gave her Haldol.

HOUSE: We needed blood for some tests. I assume that was the only way to get it.

LUKE: He knocked her out.

HOUSE: Look – I have a cane, and I know how to use it.

LUKE: I hired you. You work for me.

HOUSE: OK, can I go now? Boss? [ walks away ]

LUKE: [ calling after him ] The Haldol changes her. She says it makes her soul numb. Don’t give it to her.

[ Luke in Lucy’s room ]

LUKE: [ reading ] “If there be rags enough, he will know her name and be well pleased remembering it.” [ Lucy coughing ] You OK?

LUCY: “Old… days…”

LUKE: “For in the old days, though she had young men’s praise and old men’s blame, among the poor, both old and young gave her praise.” [ Lucy coughs again and blood spatters on page; Luke turns as she begins to vomit up lots of blood ]

LUKE: [ running for the door ] Help! Somebody, help!

[ shot of Lucy asleep ]

[ House’s office, he’s chewing out Foreman ]

HOUSE: So, when I said, “no psych meds,” I’m just curious – which word didn’t you understand?

FOREMAN: The Haldol had nothing to do with the bleed. You know that. I used it purely as a chemical restraint.

HOUSE: Oh, great, well, that’s good to hear. So she won’t experience any of those pesky little side effects you get when your motives AREN’T pure.

FOREMAN: Those side effects are so rare!

HOUSE: Passing out, increased confusion, depression, that’s not gonna happen. That’s not gonna screw up our diagnosis, ‘cause you just used it to restrain her. I’m so relieved!

FOREMAN: She spit in my face!

HOUSE: It must have been so frightening for you.

FOREMAN: What was I supposed to do? Tie her down?

HOUSE: Yeah! Anything but give her drugs – that’s basically my point!

[ Cameron is sitting at a table outside House’s office as Chase comes in with a folder ]

CHASE: The clotting studies. Pretty fast – you promise to date the entire lab?

CAMERON: No – I save that for emergencies. I told them she bled out two units and if it happened again, she’d die.

CHASE: If it’d happened at home, she would have died. That ER doc, he was gonna send her home.

HOUSE: It turns out your best judgment is not good enough. Here’s an idea – next time, use mine.

CAMERON: I think they’re choosing a movie.

[ House and Foreman come out ]

HOUSE: Why did the patient bleed out?

CAMERON: The clotting studies so far are normal.

HOUSE: Well, cover your ears if you don’t want me to spoil the ending. Everything was normal, except for prolonged PT time, which means what?

FOREMAN: Usually it means, whoever drew the blood didn’t do it right.

HOUSE: Oh, that’s right – ‘cause… you drew the blood. But you were precise, because you knew the tube was purely for the PT study.

FOREMAN: That’s right.

HOUSE: And I’m right with you. I trust this result. For two reasons, a) because you are a good doctor, and b) because five milligrams of IV Haldol makes for a spectacularly cooperative patient. The prolonged PT time makes me think she’s got a vitamin K deficiency.

CAMERON: Vitamin K would explain the bleed but not the clot.

HOUSE: Without vitamin K, protein C doesn’t work. Without protein C, she clots. Clotting and thinning, all at the same time.

CAMERON: What about another drug interacting with heparin, an antibiotic like ampicillin? That would …

HOUSE: Clever, but she’s not on ampicillin.

CAMERON: [ looking at notes ] Two months ago, she complained of a sore throat. And he got her ampicillin.

HOUSE: Which she refused to take.

CAMERON: He just said she didn’t take it. What is it, everybody lies, except for schizophrenics and their children?

CHASE: It’s more likely than malnourishment. Why not scurvy or the plague?

HOUSE: Gee, I wish my idea was as cool and with it as yours. What is yours, by the way? Do you have one?

CHASE: Alcohol. Simple. It causes immobility, which explains the DVT. It also causes cirrhosis which explains the bleed and the prolonged PT time. Let’s ultrasound the liver.

HOUSE: Three theories. Check out her place for ampicillin and diet, then ultrasound her liver. Let’s find out who’s right before she bleeds to death.

[ ducklings walk away ]

[ Chase and Foreman enter building, up stairs to apartment ]

CHASE: 101. [ pulls credit card out of his wallet to open door, struggles to open the door with it ]

FOREMAN: So House says the kid’s sensitive. Thinks he takes good care of her. If we don’t find anything, why let him know we did it in the first place? What’s the point? Why not just make old Foreman [ pulling a key out of his pocket ] lift the key from the kid’s backpack? [ Chase takes it and they go in ]

CHASE: Looks like Luke sleeps in the living room.

[ Foreman checks bathroom; Chase checks bureau drawers labeled with days of the week]

FOREMAN: Nothing in there. He lays out her clothes?

CHASE: Enough organization, enough lists, you think you can control the uncontrollable. Fix her meds, fix her clothes, maybe you can even fix her.

FOREMAN: Pick that up on your psych rotation?

[ Chase picks up a picture of Lucy and son ]

FOREMAN: [ finding strongbox ] Trifluo perazine, Thorazine, Foziril – whew, they tried everything. The ampicillin -- [ shakes bottle ] never touched it. There goes Cameron’s theory.

CHASE: Oh, God, I hope it’s not a vitamin K deficiency.

[ they go into the kitchen – empty fridge, freezer full of frozen burger dinners ]

CHASE: [ groans ] Damn.

FOREMAN: Breakfast, lunch and dinner. House was right.

[ microwave beeps; House takes out burger, goes to sit at table with Luke ]

LUKE: That’s the only thing she’ll eat.

HOUSE: Ah. Problem is, you can’t actually live on this stuff.

LUKE: I checked it out, I looked on the box, all the nutritional values were solid. There’s plenty of protein, and calories…

HOUSE: Yeah, vitamin A and C, but no K. That’s why your mom got sick.

LUKE: So, what’s the plan?

HOUSE: Load her up with vitamin K.

LUKE: That’s it?

HOUSE: If it all checks out, you can take her home in a couple of days. Oh God, you’re upset about something. You’re gonna open to me now, aren’t you?

LUKE: It’s all my fault.

HOUSE: Here we go…. OK, I’m gonna say this once. You have done a very good job taking care of your mother. If this was all she’d eat, then what else could you do? Gosh, just being a kid is a full-time job…

LUKE: Shut up! I’m 18, I should be able to take care of my mom! I almost killed her.

HOUSE: Good example, just the time it takes to express those ridiculous self-centered teenage ideas… I don’t envy your schedule. [ chomps ] No pickles.

LUKE: My mom doesn’t like them either.

HOUSE: Smart woman.

LUKE: Before she got sick, I didn’t like how bossy she was, always telling me what to do, the right way to do it. Never thought I’d miss that. [ lifting backpack, wrist pain ] Ah…

HOUSE: You should get that looked at.

[ Foreman and Chase walking down hall ]

CHASE: I still don’t buy a vitamin K deficiency.

FOREMAN: House was right. That usually makes you happy. Less work for us.

CHASE: The kid feeds his mum a steady diet of booze and the problem is too many burgers?

FOREMAN: The kid’s in a tough situation – you do what you’ve gotta do to survive.

CHASE: Feeding alcohol to an alcoholic is not a survival technique.

FOREMAN: Where I come from, if it works…

CHASE: Yeah, right. I’m rich, I couldn’t possibly understand what this kid is going through. Just because you’re drinking pricier stuff doesn’t mean you don’t have a problem.

FOREMAN: You’ve seen someone stagger down that road?

CHASE: No way vitamin K’s the whole story.

[ House and Luke in House’s office ]

HOUSE: [ putting up x-ray on lightbox ] It’s not broken. [ pointing ] See this right here? It’s the epiphyseal plate, otherwise known as the growth plate.

LUKE: What’s wrong with it?

HOUSE: Amazing thing, this bone. If you know how to read it, it can tell you how old someone really is, exactly how old.

LUKE: Great.

HOUSE: Not even fifteen. Almost, though. Two weeks away, maybe a month.

LUKE: Last week. I was fifteen last week.

HOUSE: [ walking over to his desk and sitting down ] Happy birthday to both of us. If you’re gonna lie though, go big, go 21. That way you won’t need your crazy mom to help you buy vodka.

LUKE: Great. Thanks for the tip. [ takes out notebook ] Now, when I bring my mom home, is there anything I need to know about taking care of her?

HOUSE: I suppose your biggest worry isn’t the booze. You’re 15, basically no mom. Child Welfare let kids get away with that, well, they wouldn’t need those nice foster homes, and that would make them sad.

LUKE: They’d put her someplace too. My life is working.

HOUSE: Not the word I’d use. Most 15 year old kids are doing what they’re supposed to be doing, you know, they’re huffing glue, catching crabs…

LUKE: If you turn me in, I’ll sue you. That’s privileged information.

HOUSE: Oh, relax. It’s not even your x-ray.

[ Luke is taken aback; House makes a face at him ]

[ Lucy’s room, Chase doing ultrasound of liver; Cameron comes up to him ]

CAMERON: She’s awfully calm.

CHASE: House write new orders?

[ Cameron checks drug vial ]

CAMERON: There’s a little bit of scarring, not much, not enough to con…

CHASE: It’s cirrhosis. But she doesn’t drink!

CAMERON: Congratulations, you win.

[ both goggle at the screen ]

CAMERON: Actually… no one wins.

CHASE: A tumor. Cystic?

CAMERON: Solid mass. Cancer.

[ Wilson in House’s office, looking at ultrasound ]

WILSON: The vitamin K caused the DVT, and aggravated the liver. But the tumor’s the real reason for the bleed. The tumor’s the problem.

[ in Lucy’s room ]

WILSON: Mrs. Palmeiro, I’m Dr Wilson. I’m afraid I have some bad news from your ultrasound. You have cancer.

[ As he continues, Luke puts down notebook, walks away from her bedside, overwhelmed. Lucy watches his reaction. ]

[ House and ducklings in House’s conference room ]

FOREMAN: It’s big. Five point eight centimeters.

CHASE: We do nothing, she dies from liver failure within 60 days.

CAMERON: She needs a transplant.

HOUSE: [Sarcastically] That’s gonna happen.

CAMERON: She’s a 38 years old, she’s a mother...

HOUSE: She’s a schizophrenic mother, with no money, on the public dole, in fact, who knocks back vodka every time a breeze blows her way.

[ Wilson walks in ]

FOREMAN: Mickey Mantle had a whole bar named after him. He got a transplant.

HOUSE: Yeah, well, Lucy can’t switch-hit. Plan B. Surgery to resect the tumor.

CHASE: Joe Bergen does the knife thing -- laser cauterizes while it cuts, saves more liver.

WILSON: The tumor’s way too big. He won’t even consider it.

FOREMAN: Not a big risk taker, Bergen. He won’t even drink milk on its expiration date.

WILSON: He has no discretion. Five point eight centimeters is past the surgical guidelines.

HOUSE: Would he do it at 4.6?

CAMERON: Why don’t we just say it’s zero, then we don’t need him at all. Tumors grow, they don’t shrink.

HOUSE: This one does.

[ Wilson and Cameron in Lucy’s room, Cameron with ultrasound and Wilson with honking great big syringe to inject the tumor ]

WILSON: Ninety five percent ethanol. The ethanol dehydrates the tumor cells, literally sucks them dry. Shrinks the tumor temporarily.

CAMERON: How temporarily?

WILSON: Well, if we’re lucky, just long enough to fool the surgeon.

[ House walks into the clinic as Cuddy comes out of her office ]

CUDDY: Good morning, Dr. House!

HOUSE: Good morning, Dr. Cuddy! Love that outfit. Says, I’m professional, but I’m still a woman. Actually, it sorta yells the second part.

CUDDY: Yeah, and your big cane is real subtle too.

HOUSE: Gotta go. [ walks away ] Those running noses aren’t just gonna start walking on their own.

CUDDY: The clinic can wait.

HOUSE: [ stops ] How long? Maybe we could catch a movie.

CUDDY: You should know by now my doctors have no secrets from me.

HOUSE: I don’t believe it. Who came running to Mommy?

CUDDY: It doesn’t matter who. The point is, I know exactly what you did.

HOUSE: [ realizes she’s bluffing ] You have no idea what I’m talking about.

CUDDY: [ walking over to him ] Somebody knows about a bad thing you did – that’s a big field. But somebody you think might have told me, that narrows it down quite a bit. Someone who views me as a maternal authority figure. A young person, perhaps… How am I doing? You think I’m gonna get there? Presumably hospital business. How many patients…

HOUSE: It’s Cameron. She… found out about my birthday. I thought she told you, and I’d have to stand here and smile while you gave me a sweatshirt or a fruit basket, you know, made me feel that deep sense of belonging.

CUDDY: Actually, I was just gonna remind you, you owe me six clinic hours this week.

HOUSE: Oops. [ walks away; Cuddy walks over and picks up phone ]

CUDDY: Hi, this is Dr. Cuddy. I need all the charts on Dr. House’s current patients. [ throws birthday card in wastebasket ]

[ Clinic exam room ]

PATIENT: Hiccups. I’ve tried everything.

HOUSE: Um hmm. [ reading from chart ] Pulling the tongue, icepacks on the throat, hitting yourself… the groin pinch. Well, you’ve certainly covered all the normal medical bases. Uh, how are you hitting yourself, though? Is it open hand or fist?

PATIENT: Open hand.

HOUSE: Well, that’s how they teach it at Harvard Med. How hard though?

[ Cuddy comes in; patient slaps himself ]

HOUSE: I’m sorry, I missed that. Could… could you do that again? [ patient slaps himself again ] That’s… that’s very good. [ to Cuddy ] Hiccups.

CUDDY: I need to speak with you. NOW.

HOUSE: Mmhhmmm, I need to go peepee. [ to patient ] Dial it up a notch and repeat. I’ll be back. [ he leaves, Cuddy follows, patient slaps himself again ]

[ House is washing his face in the men’s room as Cuddy walks in ]

HOUSE: Ooh, girl in the boys’ bathroom. Very dramatic. Must be very important what you have to say to me. [ dries hands and face on paper towel ]

CUDDY: Yesterday your patient’s tumor was 5.8 centimeters. Today it’s 4.6. How did that happen?

HOUSE: At a guess, I’d say “Dr. House must be really really good – why am I wasting him on hiccups?” I wash before and after. [ walks over to urinal ]

CUDDY: You also requisitioned 20cc of ethanol -- what patient was that for? Or are you planning a party?

HOUSE: [ over his shoulder ] Do me a favor…?

[ Cuddy turns on water faucet ]

HOUSE: I was gonna say “leave,” but that works.

CUDDY: You shrunk the tumor!

HOUSE: Only way to get the guy to do the surgery…

CUDDY: Fraud! Fraud was the only way. There is a reason that we have these guidelines.

HOUSE: I know – to save lives. Specifically doctors’ lives, and not just their lives but their lifestyles. Wouldn’t wanna operate on anyone really sick – they might die and spoil our stats.

CUDDY: Bergen has a right to know what he is operating on.

HOUSE: True. I got all focused on her right to live, and forgot. You do what you think is right.

[ Cameron walks into House’s office as he’s typing away on his computer; he notices her and stops ]

CAMERON: You really didn’t know.

HOUSE: No. I didn’t. And frankly I’m angry. Which I’m guessing is the correct response. ‘Course I’ll know better once you tell me what you’re talking about.

CAMERON: Your birthday.

HOUSE: Oh. Anger was a bad guess. Well, normally I’d put on a festive hat and celebrate the fact that the earth has circled the sun one more time. I really didn’t think it was gonna make it this year, but darnit, if it wasn’t the Little Planet That Could all over again.

CAMERON: It’s a birthday. It’s an excuse to be happy. You think that’s lame?

HOUSE: Why are you here? To buy me a pony?

CAMERON: I’m just waiting for the surgery.

HOUSE: Yeah well, go scrub in.

[ operating room ]

BERGEN: All right, done. Close her up. [ Bergen and Cameron begin stripping off gloves and masks ] That tumor didn’t just walk itself into a bar and order up a double shot of ethanol. Someone shrunk it down.

CAMERON: I’m sorry. It was very, very wrong.

BERGEN: House is lucky I didn’t just close her up. He tries again, that’s what happens.

CAMERON: I’ll pass it on.

[ shot of Lucy asleep, panning over to Chase and Luke ]

CHASE: It looks like the surgeon got it all, but she’s gonna have to have some chemotherapy.

LUKE: [ taking notes ] What kind is it?

CHASE: Luke, stop writing. [ he sits down at the table with Luke ] If you stop for a second, it’s not all gonna fall apart. Give yourself a break once in a while. The fact is, your mum’s gonna have an extra drink every now and then.

LUKE: No. No, she won’t, she doesn’t.

CHASE: Fine. There are some things you just can’t fix, that’s all I’m saying.

LUKE: That’s how you’d handle it, something like this? You’d just give up?

CHASE: No. I’d do it just like you. It’s an infusion. [ hands him a pamphlet ] She’s gonna have a drain in her abdomen, you’re gonna have to check for possible infections.

WYETH: [ entering room, with a guy ] Lucas Palmeiro? Trina Wyeth, Child Services, State of New Jersey.

CHASE: [ standing up ] Can I help you? This is a private room.

WYETH: He’s only 15 years old, a minor, he’s in a tough living situation -- we’re just here to help.

LUKE: I don’t need your help.

CHASE: 15?

WYETH: Lucas, you’re gonna have to come with us. Right Now.

CHASE: Where are you taking him?

WYETH: Until the determination had been made he’ll be housed at Children’s Services.

LUKE: I don’t wanna be housed, I live with my mom.

WYETH: Not for the next few days. [ Luke stands up, goes over to Lucy’s bed ] Come on, let’s not make this difficult, huh?

LUKE: Mom? Mom? I love you.

[ she wakes and turns to him ]

LUCY: The Mets lost. You remember?

LUKE: Yeah. I remember.

LUCY: I love you. [ closes her eyes; Luke picks up backpack and walks out, crying, tears streaming down his face ]

WILSON: Cuddy didn’t say anything about pushing Bergen to finish the surgery?

HOUSE: Not a word. Some kind of mind game. She’s waiting for me to crack.

WILSON: Well, either that, or she’s just being nice.

HOUSE: Yeah, well… [ Luke storms past them, followed by Child Services reps ]

LUKE: You said you wouldn’t call – you’re a real bastard, you know?

HOUSE: [ staring after them ] Yeah. I get that a lot. I don’t think Mom’s crazy.

HOUSE: [ reading to Lucy ] “For in the old days, though she had young men’s praise and old men’s blame, among the poor, both old and young gave her praise.” [ he snaps the book shut and she wakes up ]

HOUSE: You called Social Services. It was you.

LUCY: No, no. No.

HOUSE: It’s OK, it’s OK, I get it. He’ll have an easier time dealing with the system. Sure, he won’t be with his real mother, but his real mother’s sick. Someone needs to take care of him.

LUCY: I’m not gonna live here.

HOUSE: What would his future have been? Taking you to chemo and back on the bus… and even if the cancer’s in complete remission, he’ll still have a mother who hears voices.

LUCY: Talk no more, talk… no more.

HOUSE: “Look what I do to him, limpie.” You said that. I checked the phone records – only one call from this room. Smart – they charge you two bucks a call. It was to Social Services of the State of New Jersey. You’re his mother, couldn’t do it to him anymore. [ pause ] Good for you.

[ House and Wilson coming out of House’s office and walking down the hall ]

WILSON: Schizophrenics can make rational decisions.

HOUSE: On the small stuff, yeah, when to sleep, what to drink, no lemonade but I’ll take some hemlock if you’ve got it.

WILSON: Your man Socrates.

HOUSE: But giving up your son, because it’s better for him – it’s so sane, so rational. Self-sacrifice is not a symptom of schizophrenia… it excludes the diagnosis.

WILSON: She’s not schizophrenic?

HOUSE: She’s 36 years old when she first presents…

WILSON: It’s a little late, but within the parameters.

HOUSE: The internist sends her to a shrink, one shrink sends her to the next, she tells them all she’s not crazy, the drugs don’t work and why would they if she’s not a head case? She got clearer when I took her off the psych meds. [ pauses at his office door ] You think I’M crazy.

WILSON: Well, yeah, but that’s not the problem. Didn’t we just leave your office?

HOUSE: I like to walk.

[ Sounds of piano coming from 3rd floor apartment; House is playing something classical. He finishes that piece, taps out “happy birthday to you, happy birthday to you.” Takes a drink from a glass on top of the piano – scotch? Or whiskey? Looks over at Luke’s notebook, limps over to pick it up, sits back on piano stool and pages through it. ]

HOUSE: [ picking up telephone ] Is that Dr. Jeffrey Walters? Hi. My name is Greg House, I’m a doctor… oh, is that the time? Yeah, I’m sorry, my watch must have stopped. Listen, you treated a patient about eighteen months ago, a woman named Lucille Palmeiro, I wondered if you recalled running any tests… [ fades as Walters hangs up on him ] …at all. [ tries again, using a terrible English accent! ] Oh, how terribly foolish of me, doctor, is it that late? Yes, I’m calling from London, you see, must have got my times mixed up so… [ another hangup ]

[ he looks at the notebook, gathers stuff up and leaves ]

[ House and ducklings in his office; he’s pacing, and they have all obviously been woken up in the middle of the night ]

HOUSE: I have a headache. It’s my only symptom. I go to see three doctors. The neurologist tells me it’s an aneurysm, the immunologist says I got hay fever, the intensivist… can’t be bothered, sends me to a shrink, who tells me that I’m punishing myself ‘cause I wanna sleep with my mommy.

FOREMAN: Maybe you’re just not getting enough sleep.

HOUSE: Pick your specialist, you pick your disease. If it’s not schizophrenia, what else presents with psych symptoms?

CAMERON: Prophyria.

CHASE: The madness of King George.

CAMERON: What about that copper thing? What’s it called? It’s genetic – the body accumulates too much copper.

CHASE: Oh, uh, Wilson’s disease?

HOUSE: Very rare. Nice. I like it.

FOREMAN: If any of us did this, you’d fire us.

HOUSE: Well, that’s funny, I thought I encouraged you to question…

FOREMAN: You’re not questioning, you’re hoping, you want it to be Wilson’s, boom! Give her a couple of drugs, she’s OK!

HOUSE: July 17, an appointment with a Dr. Carne.

CAMERON: She didn’t keep it. She never kept another appointment with a shrink he made after that.

HOUSE: Carne is not a shrink. I looked him up, he’s an ophthalmologist. Now why would she want her eyes checked?

CAMERON: Wilson’s presents with cataracts, I think.

HOUSE: Yes, it does. It also causes slight cirrhosis, which Dr. Chase so eagerly attributed to alcohol. [ looks at them all ] So what are we still doing here???

[ Lucy’s room ]

HOUSE: Lucy! [ she snaps awake ] I don’t think you’re crazy.

LUCY: Neither do I, [ they sit her up in bed ] but I’m crazy…

HOUSE: Come on. [ they get her up, move an eye scope around to the side of her bed ]

CHASE: Put your hands on the bar, and your chin in here. Thank you.

FOREMAN: [ at the controls ] You’re gonna see a bright light, OK? Your body might be accumulating too much copper. If it is, this should help us see something called Kaiser-Fleischer rings, copper-colored circles around your corneas. [ he twiddles knobs, brings view into focus – it shows a copper ring around the cornea ] I guess we should start treating her for Wilson’s.

HOUSE: It’s what I’d do.

[ Lucy, twitching in bed ]

LUCY: [ voiceover] “I will talk no more of books, or the long war, but walk by the dry thorn until I have found some beggar sheltering from the wind and there, manage the talk until her name come round… [ camera begins to spin around the room ] …and be well pleased remembering it.”

[ camera shows Lucy, dressed, wearing reading glasses, reading from the Yeats book ]

[ still voiceover ] “For in the old days, though she had young men’s praise and old men’s blame, among the poor, both old and young gave her praise.” [ takes off glasses, sighs ]

CHASE: [ coming in ] Hi, Mrs. Palmeiro, ready to go home?

LUCY: Almost.

[ Luke comes in, they hug ]

LUKE: Mom? How are you?

LUCY: I’m good. [ they hug again ] Oh, oh, oh, you really need a haircut. [ both laugh and hug, tears falling; Chase leaves, thoughtful ]

[ Luke pushes her in a wheelchair, an aide alongside, to elevator; door opens; Luke stops when he sees House and Wilson in elevator ]

LUCY: Dr. House! Luke, you’re making Dr. House wait!

HOUSE: That’s OK, we’re just here for the music.

LUCY: Luke, come on. [ they all get in, the door closes ] I’m being discharged.

HOUSE: I heard a rumor.

LUCY: Thank God I had cancer, huh? It’s terrible having everybody think you’re nuts…

HOUSE: Really?

LUCY: I called to thank you, did you get my message?

HOUSE: Yes. You’re welcome.

LUKE: [ resentful ] I’m never thanking you. You turned me in. I told you we were doing OK, it was none of your business. [ Lucy looks uncomfortable ]

HOUSE: Look. I don’t care how you were living. I just wanted you out of MY life. That’s why I had Dr. Cuddy call Social Services.

[ House looks at Wilson, then at Luke, Lucy stares straight ahead. The door opens, they wheel out. House and Wilson stand watching them go. ]

WILSON: You OK?

HOUSE: You were right. It wasn’t the DVT. It was the schizophrenia.

WILSON: I know.

HOUSE: She’s not nearly as interesting any more.

WILSON: Isn’t it your birthday around now?

[ House closes his eyes, wincing ]


END

Season 1 X 05: Damned If You Do

Original Airdate: 12/14/2004
Written by: Sara B. Cooper
Directed by: Greg Yaitanes
Transcript by: Mari

BEGINNING

[Opens on the clinic front desk. Wilson is working on paperwork, House is playing with candies. The desk has Christmas decorations on it, and “Rudolph the Red-Nosed Reindeer” is playing in the background.]

House: We are condemned to useless labor. [House has a giant stack of charts next to him.]

Wilson: Fourth circle of Hell. Charting goes a lot faster when you eliminate the whole of classic poetry. [House flicks a candy at him.]

House: Writing down what we already know to be read by nobody. Pretty sure Dante would agree that qualifies as useless.

Wilson: You’re over two weeks behind on your charting. [House flicks another candy; it almost goes down Cuddy’s shirt.]

House: Oops. I missed.

Cuddy: What are you, eight?

House: Could an eight-year-old do this? [He makes a face. Wilson smiles.]

Cuddy: You better stop or it’ll stick that way. You have a patient in Exam Room 1.

House: Yeah, but see, see, I’m off at twelve and it’s already five of.

Cuddy: She’s been waiting for you since eleven. [Cuddy walks off.]

House: Melancholy without hope. Which circle is that?

[House walks into the exam room, sees who’s in there, and makes a “oh no” kind of face. It’s three nuns.]

House: Hi. I’m Dr. House. What seems to be the problem?

Sr. Eucharist: Show him your hands, Augustine. [House pops a couple Vicodin. Augustine shows her hands, which are red, swollen, and covered in hives and sores.]

Sr. Pius: It looks like… stigmata.

Sr. Eucharist: Shhhh, Pius!

House: You must be all the talk around the holy water cooler. You been washing a lot of dishes recently?

Sr. Augustine: I help out in the kitchen.

House: Anything new in the kitchen?

Sr. Pius: We just got a donation of saucepans and pots this week.

Sr. Augustine: I unpacked and washed them.

House: Should have spent your time saving souls, it’s easier on the hands. This is contact dermatitis; you’re allergic to dish soap.

Sr. Eucharist: Nonsense! We’ve always used that soap. Why is there a problem now?

House: I’ve been a doctor for years. Why do I have to keep assuring people that I know what I’m doing? A person can become allergic to substances that they’ve had repeated and prolonged exposure to. The good news is: free samples. Diphenhydramine. It’s an antihistamine. It’ll stop the allergic reaction. Take one every eight hours, it might make you feel a little sleepy. And get some of that over-the-counter cortisone cream.

Sr. Augustine: Thank you, Doctor.

House: You want some water? [He hands her the pills.]

Sr. Augustine: I have some tea.

House: Well, you just relax for a few minutes. That stuff works pretty fast. [He leaves. The other sisters help Augustine take the medication with her thermos of tea. House to the clinic main desk and throws the chart down on the pile of other ones.]

Wilson: Still out by twelve.

House: How do you solve a problem like dermatitis?

Wilson: What?

Sr. Eucharist: Doctor? I want to thank you for your patience.

Wilson: She talking to you?

House: I don’t know. She’s certainly looking at me.

Sr. Eucharist: Oh, it’s good to get a secular diagnosis. The sisters tend to interpret their diagnosis as divine intervention.

House: And you don’t? Then you’re wearing an awfully funny hat.

Wilson: Oooh, boy. Excuse me. [He leaves.]

Sr. Eucharist: If I break my leg, I believe it happened for a reason. I believe God wanted me to break my leg. I also believe He wants me to put a cast on it. [House smiles slightly.]

Sr. Pius: Doctor, something’s wrong!

[Cut to Exam Room 1, where Augustine is having an asthma attack. House grabs his stethoscope.]

House: Lift up your chin. [He listens to her breathing.] Sister, you’re having an asthma attack. I need you to relax. [to Eucharist] Roll up her sleeve, please. [He grabs a syringe from the cabinet.] I’m giving you epinephrine, it’ll open your lungs and help you breathe. [He sticks the needle in her arm, CGI shot of the bloodstream going to her lungs, and the airways opening.]

Sr. Eucharist: What happened?

House: Did she take the pill?

Sr. Eucharist: Yes.

House: It’s probably an allergic reaction.

Sr. Pius: She’s allergic to an anti-allergy medicine?

House: You figure somebody’s out to get her? How’re you feeling?

Sr. Augustine: Better.

House: I’ll put you on some steroids instead.

Sr. Augustine: Is my heart supposed to be feeling so funny?

House: It’s called adrenaline, it makes your heart beat fast. [He feels her pulse.] But not this fast. [to the others] Get a nurse, please. Lie back.

Sr. Pius: Help! Somebody help us! [House opens Augustine’s shirt and listens to her heartbeat.

House: Somebody get in here! [A tech comes in.] Call a code and charge up a defibrillator. She’s got no pulse. [The tech runs out, House starts chest compressions.]

[ Opening credits.]

[Cut to Augustine’s hospital room. Her cross and Bible are on the table next to her; the two sisters are praying at her side. Cut to Cuddy’s office.]

Cuddy: You diagnosed the patient with allergies and prescribed antihistamine, she went into respiratory distress, and you injected her with epinephrine. Presumably 1 cc.

House: 0.1 cc. That is the standard dose, that is what I gave her.

Cuddy: People don’t go into cardiac arrest from 0.1 cc epinephrine.

House: She must have a pre-existing heart condition that got exacerbated by the epinephrine.

Cuddy: It’s too bad you didn’t make a notation in the chart.

House: I can make it up right now.

Cuddy: The drawer has syringes with both dosages, you could have easily reached for the wrong one.

House: But I didn’t.

Cuddy: Everyone makes mistakes. This is why doctors pay through the nose for malpractice insurance.

House: Relax, they’re not going to sue. Worse they’d do is whack my hand with a ruler.

Cuddy: And the discipline board? Are they gonna whack your hand, too?

House: You’re going to report me?

Cuddy: What choice do I have?

House: Uh, how ‘bout not report me?

Cuddy: I can justify keeping her here for 24-hour observation. If you haven’t found an underlying cause for the cardiac arrest by then I will have to notify our attorneys. [House looks at his watch and walks out.]

[Cut to House walking down the hall with Cameron, Chase and Foreman.]

Cameron: Her hands were red and swollen, maybe she has a skin infection. Cellulitis? That could manifest with tachycardia.

Foreman: There’s no history of fever. Results from the CBC didn’t indicate an infection.

Cameron: The eosinophils were mildly elevated, sed rate’s up a bit. Could be looking at a systemic allergic response.

House: It’s not allergic. Allergies don’t cause cardiac arrest like this. Could be inflammation of the blood vessels.

Foreman: Vasculitis? That wouldn’t give you an elevated eosinophil count.

House: Church-Strauss vasculitis would. Blood vessels of the heart, lungs and skin become inflamed causing the asthma, rash and heart problems. Covers all her symptoms. [They reach the diagnostic office.]

Cameron: Need a biopsy to diagnose.

Chase: Chest CT’d be quicker.

Foreman: The lady just came in with a rash. [House stops and stares at a bunch of candy canes on the table.]

House: What the hell are those?

Cameron: Candy canes. [Foreman takes one.]

House: Candy canes? Are you mocking me?

Cameron: No! It’s Christmas and, and I, I, I thought –

House: Relax. It’s a joke.

Foreman: Isn’t the prognosis for Church-Strauss a bit grim?

Cameron: Yeah. Untreated only 33% of patients survive past a year; treated, five years.

House: Then I’d definitely suggest treatment.

Foreman: If it was any other attending doctor, I’d say that he made a mistake and gave her too much epinephrine.

House: [pouring coffee] Saying you wouldn’t say it was my mistake is saying it was my mistake.

Foreman: Everyone screws up: your rule. I think you fit inside the subset of “everyone”.

House: I didn’t screw up. [Foreman shakes his head.] Order a chest CT and start the sister on prednisone, 40 mg. TID.

Chase: The sister?

House: Oh, didn’t I mention? The patient’s a nun. Sister Augustine.

Chase: Aw. I hate nuns.

House: [thinks a little] Who doesn’t?

[Cut to a TV, showing a man and a women playing in the waves. Sisters Augustine and Pius are watching it raptly. Foreman, Cameron and Chase walk in.]

Cameron: Sister Augustine? [Pius hurriedly turns the TV off.]

Augustine: We weren’t watching.

Pius: [holds up remote] We were trying to see if this was the bed control.

Cameron: Oh, um, this one’s the bed control [she gives Pius another remote] and that one’s the TV control. I’m Dr. Cameron, and that’s Dr. Chase and Dr. Foreman.

Augustine: I hadn’t seen television in over twenty years.

Chase: Do you consider it the work of the devil, or do you just not get cable where you live? [pause]

Foreman: Um, how’re you feeling, Sister?

Augustine: I seem to be a little better; they gave me some medication.

Foreman: Prednisone. It’s a steroid to help with the inflammation.

Augustine: Has Dr. House figured out what I have? Will I be okay?

Cameron: We’re not sure what’s wrong yet. You’ll have a chest CT scan this afternoon that will help with the diagnosis.

Pius: Dr. House is giving her medication and he doesn’t know what she has yet?

Augustine: Trust, Sister Pius. It all happens for a reason.

[Cut to the ducklings in the hallway.]

Foreman: He doesn’t know what he’s doing. The only problem that woman has is that House grabbed the wrong syringe.

Cameron: You don’t trust him?

Foreman: I don’t trust a man who won’t admit he might be wrong. I notice you weren’t so quick to tell her she has Church-Strauss and only has a couple years to live.

Cameron: I don’t tell patients bad news unless it’s conclusive.

Foreman: Because you know he might be wrong.

Cameron: About Church-Strauss, not about what happened in the clinic.

Foreman: What about you, Chase? You think he’s infallible, too?

Chase: All I know is, if House didn’t make a mistake and Sister Augustine has Church-Strauss, he’ll be self-satisfied and our lives will be good for a few weeks. If House did make a mistake, he’ll be upset and our lives will be miserable for months.

Foreman: There is that.

[Cut to House and Wilson walking out of the elevator and into the clinic.]

House: If Cuddy thinks I made a mistake the least she could do is suspend me from clinic duty.

Wilson: She doesn’t confuse making a mistake with being incompetent.

House: Oh, here we go. Lesson time. I recognize that confidence is not my short suit. I also recognize that I am human and capable of error.

Wilson: So you might have screwed this up?

House: No.

Wilson: So, it’s only a theoretical capacity for error.

House: Good point. Maybe there isn’t one. Maybe that’s my error.

Wilson: You know, most people who think as much of themselves as you do like to talk about themselves.

House: Most people don’t like to listen, so what’s wrong with you? [He leaves Wilson standing in the clinic.]

[Cut to House entering Exam Room 1, which is occupied by… Santa Claus? House makes a point of sniffing the air as he enters.]

House: Let me guess… inflammatory bowel.

Santa: Wow, yeah. Is it that bad?

House: Yes. It’s also written on your chart. Bloody diarrhea, gas, pain… took sulfasalazine, but it didn’t work –

Santa: No, then I –

House: Next tried steroid enemas, oral corticosteroids, 5ASAs, 6 mercaptopurine… I’m impressed.

Santa: By my medical history?

House: By how well your last doctor charted.

Santa: It’s one thing to have to go to the bathroom every hour, but when the kids sit on my lap, it’s…. The store sent me home, they’re gonna fire me. Can’t you put me back on 5ASA? Maybe it’ll work this time?

House: Not likely. I’m giving you a prescription. It’s cheap, which is good because your insurance company won’t pay for it. [He gives Santa a prescription, who puts on his glasses to read it.]

Santa: [tries to read House’s writing] Cojorius?

House: Cigarettes. One twice a day, no more, no less. Studies have shown that cigarette smoking is one of the most effective ways to control inflammatory bowel, plus it’s been established that you look 30% cooler.

Santa: Are you kidding me?

House: About the looking cooler, yeah. The rest is true.

Santa: Isn’t it addictive and dangerous?

House: Pretty much all the drugs I prescribe are addictive and dangerous. The difference with this one is that it’s completely legal. [He turns to leave.] Merry Christmas.

[Cut to Chase wheeling Augustine to the CT.]

Augustine: I was talking to the nurse, Arsenio. Do you know him?

Chase: Not really.

Augustine: He can take pictures with his phone.

Chase: Cool.

Augustine: That woman from the lab was interesting, too. She studied astrophysics before becoming a nurse.

Chase: You know the staff better than I do.

Augustine: Well, I love to hear about people.

Chase: Yet you live in a monastery.

Augustine: It’s where I serve our Lord and the world best.

Chase: Our Lord, maybe. The rest of the world, on the other hand, would probably get more out of feeding the homeless or –

Augustine: Healing the sick?

Chase: As an example, yeah.

Augustine: Did you always want to be a doctor?

Chase: Always. You always want to be a nun?

Augustine: My parents died when I was six. I was raised in a foster home run by the Church. When I was eighteen, I went to the monastery where they let me take my vows. I’ve known no other life and I haven’t wanted to.

[Cut to Augustine going into the CT.]

Foreman: Okay, Sister, we need to you lie as still as possible. If you get scared, just let us know.

Augustine: As Jonah said from inside the whale, “When I had lost all hope, I turned my thoughts to the Lord.”

Foreman: At least she’s got God on her side.

Cameron: I don’t believe in God.

Foreman: You’re not even a little agnostic?

Augustine: [from inside the CT] Is it supposed to smell funny?

Tech: Someone ralphed in there this afternoon. We cleaned it up, but…

Cameron: It’s normal, Sister. It’s just a few more minutes. [pause] I believe in a higher order that’s in control of what happens, but not one anthropomorphic entity called “God” that’s concerned with the everyday workings of you and me.

Foreman: What else is there to control but the everyday workings of you and me?

Cameron: It’s always about you, Foreman.

Foreman: What else are you talking about? The trees, the fish? Should they be the ones to think it’s all about them? What about you, Chase? Do you believe in God?

Chase: I believe Sister Augustine has no vascular pathology, which means no Church-Strauss.

Foreman: Which means House made a mistake.

Cameron: No, not necessarily. It could be something else. Thyrotoxicosis or a carcinoid.

Foreman: I don’t get you. You don’t believe in God, but you’re willing to put complete faith in one man?

Augustine: Please, the smell!

Foreman: Let’s get her out of there. [Augustine is panicking as they pull her out.]

Cameron: I’m coming, Sister. I gotcha, I’m coming.

Augustine: Please, please, the smell, I’m sick –

Cameron: There’s no smell –

Augustine: No, God, no – [she puts her hands in a praying position, then gestures outward] Oh, it’s Jesus! It’s Jesus! [Chase rolls his eyes. Augustine starts to laugh and cry.] He’s coming for me. He’s burning me with his touch!

Foreman: Let’s get her on some Ativan. [He holds on to Augustine’s arms as she continues to cry.] Smells, religious visions are symptomatic of temporal lobe swelling. We don’t want her to –

Augustine: Oh!

Cameron: She’s seizing!

Foreman: Help me get her on her side. [The three of them maneuver the sister onto her side.]

Chase: Religious visions?

Foreman: Yeah. And next comes… [he lifts up part of her gown, we see a rash on her leg. Chase and Foreman share a look.]

[Cut to the diagnostic office.]

Foreman: Patient tested positive for herpetic encephalitis.

House: So what’s that tell us?

Cameron: Her immune system is severely compromised.

Cuddy: Ooh, I know! Prednisone compromises the immune system. Isn’t that the medicine you gave her for the thing she doesn’t have?

House: Yeah, but… hey. I’m think that’s a trick question.

Cameron: Her immune system is severely compromised. Two doses of prednisone wouldn’t do that.

Cuddy: Are you hanging your diagnosis on an adverb?

House: In ten seconds I’m gonna announce that I gave her the wrong dose in the clinic.

Cuddy: You’re gonna admit negligence?

House: Unless you leave the room. If you leave you’ll have to testify. [Cuddy stays put.] Five, four, three, two…. So, there I was in the clinic, drunk. I open the drawer, close my eyes, take the first syringe I can find – [the ducklings smile, Cuddy leaves] So, what are the options for compromised immune system?

Chase: Mixed connective tissue disease. It’d explain why she was feeling better on the prednisone.

Foreman: Sure, she was feeling better right up to the moment it almost killed her.

House: On the other hand, it explains the symptoms. Swollen hands, pulmonary problems, cardiac problems – it all fits.

Foreman: Except her ANA was normal.

House: So redraw the blood.

Foreman: But the treatment is cortical steroids, prednisone, and we can’t go there because of the encephalitis.

House: Then we’ll treat it with something that modulates the immune system but doesn’t suppress it. Hypobaric oxygen chamber.

Foreman: There’s no protocol for putting a patient in a high-pressure oxygen room to treat autoimmune problems.

House: Oh, you people. Always with the protocols. [small pause] Prep the nun and discontinue the prednisone. [He begins to erase the whiteboard and continues to talk to Foreman as the others leave.] I am both amused and annoyed that you think I should be less stubborn than you are.

Foreman: You are aware of the Hippocratic Oath, right?

House: The one that starts: First, do no harm, then goes on to tell us no abortions, no seductions, and definitely no cutting of those who labor beneath the stone. Yeah, took a read once, wasn’t impressed.

Foreman: Hypobaric treatments could cause oxygen toxicity, lung and eye damage –

House: Every treatment has it’s dangers –

Foreman: Which is why we treat when we’re only convinced the patient needs the treatment.

House: I’m convinced. You’re not. Question is, what are you going to do about it? Hmm?

[Cut to Cuddy’s office.]

Cuddy: [on the phone] I have an opening Thursday at three. Do you have a fourth? Is he any good? [Someone walks into her office.] Can I call you right back? Okay. [She hangs up.] What’s up? [We see that it’s Foreman that walked into her office.]

[Cut to Chase and Cameron putting Augustine into the hypobaric chamber.]

Chase: The pressure will force the oxygen into your system and saturate your blood. It will enhance white cell activity and reduce the inflammation.

Augustine: And that will help with this mixed connective tissue disease?

Chase: We’ll be doing about ten treatments and then we’ll reevaluate.

Augustine: The last treatment with prednisone cause the seizures, right? How confident is Dr. House about this?

Cameron: That you reacted so strongly to the prednisone let us know that you had an underlying problem with your immune system.

Augustine: I guess it was a blessing… of sorts.

[Cut to the hospital chapel. House is sitting in the chapel watching General Hospital on his portable TV.]

Soap Doc: So, who’s your favorite reindeer, Nurse [something]?

Soap Nurse: Rudolph.

Soap Doc: I would have thought it was Vixen.

Soap Nurse: What are you implying?

Soap Doc: Nothing, but I saw you at the Christmas party with Dr. [fades out. Sr. Eucharist walks in, makes the sign of the cross, and turns to sit. She sees House in the pew.]

Eucharist: This is a chapel. A house of prayer.

House: House of prayer, huh. That explains the good reception. Also why nobody’s ever here.

Eucharist: I need to talk with you, Dr. House. Sister Augustine believes in things that aren’t real.

House: I thought that was a job requirement for you people.

Eucharist: She’s been known to lie to get sympathy. She’s a hypochondriac.

House: [turns off TV] So, you’re warning me that I may be treating a non-existent ailment

Eucharist: Sore throats, joint pains… there’s always something wrong, and there’s never a reason for it. Mother Superior plays right into it. Lets Augustine off work duties, treating her as fragile, special.

House: That must make you angry. [eats a piece of chocolate]

Eucharist: It bothers me. It’s not really in Augustine’s best interests. [She keeps looking at the chocolate bar.]

House: [offers the chocolate] Want some?

Eucharist: I shouldn’t. [takes the bar and sits down next to House]

House: I guess you’ve got to be good at reading people to be a good infirmarian, huh.

Eucharist: [around a mouthful of chocolate] Mm hmm.

House: So, we’ve got pride, anger, envy, gluttony…. That’s four out of seven deadly sins in two minutes. Do you people keep records of these things? Is there a Cathlympics?

Eucharist: They say you have a gift.

House: They like to talk.

Eucharist: You hide behind your intelligence.

House: Yeah, that’s pretty stupid.

Eucharist: And you make jokes because you’re afraid to take anything seriously. Because if you take things seriously, they matter, and if they matter –

House: And when things go wrong, I get hurt. I’m not tough, I’m vulnerable.

Eucharist: I barely know you, and I don’t know if I’m right. I just hope I am. Because the alternative is, you really are as miserable as you seem to be. [pause]

House: You know, from the way you’re looking at me right now, I’d say you just hit number five: lust. [Eucharist hands House his candy bar and leaves. House pulls out his pocket TV.]

Soap Nurse: Dr. Brown, I love you, too.

[Cut to Cameron and Chase opening the hypobaric chamber.]

Chase: How’re you feeling?

Augustine: A little weak.

Chase: That’s from the oxygen.

Augustine: My mouth is dry.

Chase: Okay. well, I’ll get you some of your tea.

[Cut to House and Cuddy walking down a hallway.]

Cuddy: Mixed connective tissue disease? Her ANA is barely elevated!

House: Well, thanks for checking up on her. Good to know you’ve got my back.

Cuddy: 0-2 stat is down to 83, pulmonary problems, breathing problems –

House: Irritation from the oxygen is typical.

Cuddy: She comes in with a rash and you put her into cardiac arrest.

House: That well just never runs dry, does it? If there was no underlying problem, then why is she still having the rapid heartrate?

Cuddy: Maybe from the herpetic encephalitis caused by you giving her prednisone!

House: Her reaction is a symptom, not an error.

Cuddy: There’s always an explanation, isn’t there?

House: Yes, there is! And if this one doesn’t work will find another.

Cuddy: But never one involving you screwing up.

House: One that fits all the facts. Look, we obviously have a difference of opinion, and that’s fine, but unfortunately I’ve used up all the time I’ve budgeted today for banging my head against a wall.

Cuddy: I am going to do you the biggest favor one doctor can do for another. I am going to stop you from killing your patient. You’re off the case.

[Cut to House, standing in his office. He gives Foreman a Look, who Looks right back at him. House then gives him quite an evil grin, and Foreman… well, he’s got nothing on that.]

[Cut to the ducklings talking with Cuddy in her office.]

Cuddy: We’re going to treat the symptoms.

Cameron: Not the underlying condition?

Cuddy: There is no underlying condition. What’s her status?

Chase: The sister’s breathing is labored.

Cuddy: Pneumonitis from the hypobaric chamber. Put her on 40% oxygen until her 0-2 stats increase.

Chase: BUN and creatin’s rising, ALT and AST twice the normal range.

Cuddy: Could be from the hypertensive episode. Let’s follow them with labs.

Foreman: She still has the rash and the joint pain she came in with.

Cuddy: Order a non-steroidal anti-inflammatory.

Cameron: When we were looking at the differential diagnosis with Dr. House, we were considering –

Cuddy: I don’t need to hear what Dr. House was considering! All of this woman’s symptoms can be traced to Dr. House’s considerations. Okay. Let’s just get this patient healthy. I want her going out the front door, and not the back.

[Cut to Cameron, Chase and Foreman leaving the clinic.]

Foreman: Hey, it’s not like I betrayed him. Cuddy would have found out about the hypobaric treatments eventually.

Cameron: You did what you felt you had to.

[Cut to House in the clinic. He’s looking through the door with the epinephrine syringes.]

Wilson: Can’t get enough of this place, huh?

House: Came for my stethoscope.

Wilson: So, I shouldn’t read too much into the fact that you were looking for it in the drawer with the epinephrine syringes in it?

House: Okay, yeah. I’d like to clear my reputation.

Wilson: Oh, right. I forgot that you care about what people think. Prescribing cigarettes for inflammatory bowel? It could cause lung cancer, you know.

House: [leaving the exam room] You know why they have ribbons for breast cancer, colorectal cancer, prostate cancer and not for lung cancer?

Wilson: They ran out of colors?

House: It’s because people blame lung cancer patients. They smoked, they screwed up, they deserve to die. The reason people die from lung cancer is guilt. [He enters Cuddy’s office where the records are kept.]

Wilson: Huh. Well, guilt does a lot of damage.

House: You said that with great significance.

Wilson: You’re not here to find your stethoscope. You’re not here to clear your reputation. You’re here because you’re having doubts. You might have screwed up.

House: I’m here because, if I’m right, Cuddy is killing that patient.

Wilson: Okay, but if you’re wrong? [pause]

House: Then she’s saving her.

Wilson: Fine. You’re going to have to go through every record of every patient who’s been through this clinic in the last two days, and you’re gonna have to hope that those records can be trusted, which, by the way, yours can’t. [Wilson leaves.]

[Cut to Chase with Augustine.]

Chase: These pills will help your kidneys function a little better, Sister. [She takes the pills.] Get your wrist? [He takes her pulse.]

Augustine: What’s that?

Chase: 104.

Augustine: Is that good?

Chase: It’s fine.

Augustine: You’re a lousy liar, Dr. Chase. [Chase’s beeper goes off. On it is the message “Call Mom!”

Chase: I have to get this. Excuse me.

[Cut to House’s office. House is playing with a yo-yo. Chase enters.]

Chase: My mother’s been dead for 10 years.

House: But she’s always with you in spirit. What do you know about the nun?

Chase: Which one?

House: The cute one. I think she likes me. The sick one, obviously.

Chase: Her parents died when she was a child and she’s been with the Church ever since.

House: What’s she lying about?

Chase: Why do you say that?

House: I always say that. And the old nun says the sick nun is a big fat nun liar. You know nuns, what do you think?

Chase: I don’t know nuns.

House: You hate nuns. You can’t hate someone if you don’t know them.

Chase: Know any Nazis? Maybe I hate them on principle.

House: I have a theory on what makes good boys “good”. It’s not because of some moral imperative. Good boys have the fear of God put into them. Catholic Church specializes in that kind of training, to make good boys afraid of divine retribution so they will do what their daddies tell them, like, for example, going into medical school when it’s the last thing they want to do. What do you think?

Chase: I think if she did have a secret, her boss would know. [He leaves.]

[Cut to the monastery. House is talking to another nun {I’m assuming the Mother Superior.]

House: Did you paint, or put in new carpets recently?

Nun: No.

House: Any way she could have got access to drugs?

Nun: Well, we lock all of our medications in the infirmary, and we don’t keep prescription drugs here. [Nun is making tea.] Why haven’t you asked Sister Augustine about these things directly?

House: I’ve found that when you want to know the truth about someone that someone is probably the last person you should ask.

Nun: Ah. And have you been speaking to Sister Eucharist?

House: She ratted out her fellow sister pretty quickly. If I were you I’d have her repeat a year of nun school. [Nun chuckles.]

Nun: Becoming a nun doesn’t make you a saint.

House: Becoming a doctor doesn’t make you a healer.

Nun: Just because we live in a monastery and we spend most of our time in prayer doesn’t mean we don’t find time for drama.

House: So, what is the sick one’s drama?

Nun: Sister Augustine lived in Catholic foster care until she came to us. [kettle whistles] Tea?

House: Sure. Do all of you lie? It’s a good strategy, simpler when you all tell the same lie, but she has not spent her entire life as a good Catholic. When she had a cardiac arrest I had to open her blouse to do CPR and I learned two things: nuns can have nice breasts, and she has a tattoo on her shoulder of a skunk. Now, maybe it’s the Sacred Skunk of Joseph, but as far as I know, Catholic foster care and monasteries do not keep tattoo parlors in their refractories.

Nun: We consider that our life begins when we put on our habits and take our vows. What happens before then –

House: Is irrelevant to you, but it’s relevant to me.

Nun: Sister Augustine went into foster care when she was six years old, but she left when she was twelve. She lived on the streets, she got into drugs. When she was fifteen, she became pregnant, tried to self-abort. She lost the child, she became ill. We took her in when she came back. If we had thought it was medically relevant we would have told you.

House: It’s not. [He takes a sip of tea, then looks at it.] This tea is delicious. Local herbs?

[Cut to Cuddy and the ducklings in a hallway.]

Cuddy: Any change with medication?

Chase: Yeah, she’s getting worse. Lung function’s deteriorating, BUN and creatin are continuing to rise. She’s starting to run a fever and the rash is spreading. At this rate she’s not going to make Christmas.

Cameron: Maybe House was right. Maybe there is an underlying condition that explains the symptoms, something we haven’t considered.

Cuddy: Like what?

Cameron: It could be a metabolic disorder.

Cuddy: Specifically?

Cameron: Mitogenetic.

Cuddy: Specifically?

Cameron: I’m just saying –

Cuddy: You’re just saying you think House is right.

Cameron: Might be right.

Cuddy: Of course he might be right! It might be the Hand of God at work. Don’t say it’s something else unless you’ve got something concrete to offer. [A teabag is thrown onto Cuddy’s paperwork, she picks it up and stares at the entering House.] What’s this, hemlock?

House: “I’m going to do you the biggest favor one doctor can do another. I’m gonna stop you from killing your patient.” It’s figwort tea. Great for that little pick-me-up we’re all looking for in the morning. Opens the lungs, increases the blood pressure, stimulates the heart. Unfortunately, if you then get injected with even 0.1 cc of epinephrine: instant cardiac arrest. Still, what the hell, it tastes great.

Cuddy: Sister Augustine –

House: Has been drinking it religiously, so to speak.

Foreman: Take the cardiac arrest out of the equation…

House: All the rest of the symptoms can be explained by a severe long-term allergic reaction.

Foreman: That’s what Cameron said in the beginning.

House: Yes, she did. Well done. [Cameron smiles.] But your unwillingness to stick by your diagnosis almost killed this woman. [No more smiles.] Take a lesson from Foreman: stand up for what you believe. Okay, let’s go figure out how to save a nun. [He leaves.]

Chase: Damned if you do, damned if you don’t.

[Cut to House and the Ducklings walking to the diagnostic office.]

House: Because it’s been untreated for so long, it’s gone from a simple watery eyes, scratchy throat allergy to a whopping I’m-gonna-kick-your-ass allergy, compromising her immune system, diminishing her ability to heal and breaking down her organs systems. So, what’s the source?

Chase: The dish soap.

House: No, symptoms persisted days after the dishwashing episode. It’s gotta be something she’s been exposed to here in the hospital as well as the monastery.

Foreman: Well, what about the tea? It caused her arrhythmia.

House: Could be, but it’s not definitive.

Chase: We’ll skin test for allergens.

Cameron: Not yet, she’s too reactive. She’d test positive for everything. We need to stabilize her, isolate her from all possible allergens. Give her system a rest.

Chase: Get her in a clean room.

House: Okay. And we’ll gradually introduce allergens and see how she responds. When she reacts to something we’ll know that’s what killing her.

[Cut to the ducklings helping Augustine in the clean room.]

Foreman: There you go. No television, no books.

Augustine: Not even my Bible?

Foreman: I’m afraid not. This room has filtered air, filtered water… you even have silk sheets. Very decadent and hypoallergenic. You should be feeling better here. [Foreman and Cameron leave.]

Chase: We’ll be back to check on you in a little while.

Augustine: Can the other sisters come in and pray with me?

Chase: It’d be better if you don’t have any visitors. Once we isolate what’s causing your allergy, then we can be a little more lax. [Augustine turns away from the window and starts to cry.] I can pray with you.

Augustine: I want to die. Why has He left me?

Chase: I was in seminary school. They asked us once what our favorite passage was. I chose 1 Peter 1:7. “These trials only test your faith to see whether or not it is strong and pure. Your faith is being tested as fire tests gold and purifies it.”

Augustine: “And your faith is far more precious to the Lord than pure gold; so if your faith remains strong after being tested, it will bring you much praise and glory and honor on the day of His return.”

Chase: He hasn’t left you. The only thing in the way of your knowing if he’s left you is your fear. You have a choice: faith or fear. That’s the test.

Augustine: Do you think faith doesn’t mean I won’t die?

Chase: It will affect how you experience your death, and therefore your life. It’s up to you.

Augustine: Why did you leave seminary school.

Chase: A test. You passed. I didn’t.

[Cut to Cameron and Foreman talking to Pius and Eucharist.]

Cameron: We’ll call you if anything changes.

Eucharist: Will she be all right?

Foreman: As long as she’s not exposed to anything that will aggravate her allergy, she’ll be fine. [Chase comes and knocks on the window.]

Chase: Need some help in here! [Cameron and Foreman start to suit up.] Screw the procedure, she’s in anaphylactic shock!

Foreman: No way, she’s in the damn clean room.

Chase: You kidding me? Get in here! [Cameron and Foreman run in.] 0.1 cc of epi.

Foreman: Gonna have to intubate.

Cameron: I got it. [They insert a breathing tube.] I’m in. [They start to pump air.] Breathing’s stabilized.

Chase: It’s a clean room!

[Cut to House and Wilson looking through the glass.]

House: How do you get an allergic reaction in a clean room?

Wilson: Maybe it was the preservatives in the IV?

House: Checked that.

Wilson: Latex tubing?

House: Checked that. Checked everything.

Wilson: Well, it could be mast-cell leukemia. It can cause anaphylaxis.

House: Checked the blood levels. And it’s not [he mutters a couple of diseases she didn’t have, I couldn’t catch it].

Wilson: Maybe it’s just divine will.

House: It’s not my will. [takes a couple of Vicodin]

Wilson: You do realize if you’re wrong, about the big picture that is, you’re going to burn, right?

House: What do you want me to do? Accept it, pack it in?

Wilson: Yeah. I want you to accept that sometimes patients die against all reason. Sometimes they get better against all reason.

House: No, they don’t. We just don’t know the reason.

Wilson: I don’t think the nuns would agree with you on that.

[Cut to House, pacing in his office. Cameron knocks on his office door and enters.]

Cameron: I just wanted to say that I know that you did everything you could.

House: I don’t need verification from you to know that I’m doing my job well. That’s your problem, not mine.

Cameron: I was just being nice.

House: Yeah, well, you don’t need to always do that. [pause]

Cameron: Merry Christmas. [She hands House a present. Chase enters.]

Chase: Sister Augustine’s been extubated.

House: Good.

Chase: She’s requested to check out against medical advice. She wants to go back to the monastery.

House: Well, talk her out of it.

Chase: I think I may have talked her into it.

[Cut to House entering the clean room.]

House: Room’s paid up for the rest of the week. You might as well stick around.

Augustine: This illness is a test of my faith. If it’s His will to take me, it doesn’t matter where I am. I can accept that.

House: Does anybody believe anything you say? You’re not accepting. You’re running away. Just like you always do. You ran away from the monastery, you get laid, you ran away from the real world when getting laid didn’t work out so good. Now things aren’t working out again, so off you go.

Augustine: Why is it so difficult for you to believe in God?

House: What I have difficulty with is the whole concept of belief. Faith isn’t based on logic and experience.

Augustine: I experience God on a daily basis, and the miracle of life all around. The miracle of birth, the miracle of love. He is always with me.

House: Where is the miracle in delivering a crack-addicted baby? Hmmm? And watching her mother abandon her because she needs another score. The miracle of love. You’re twice as likely to be killed by the person you love than by a stranger.

Augustine: Are you trying to talk me out of my faith?

House: You can have all the faith you want in spirits and the afterlife, and heaven and hell, but when it comes to this world, don’t be an idiot. ‘Cause you can tell me you put your faith in God to put you through the day, but when it comes time to cross the road, I know you look both ways.

Augustine: I don’t believe He is inside me and is going to save me. I believe He is inside me whether I live or die.

House: Then you might as well live. You’ve got a better shot betting on me than on Him.

Augustine: When I was 15, I was on every kind of birth control known to man, and I still got pregnant. I blamed God. I hated Him for ruining my life, but then I realized something. You can’t be angry with God and not believe in him at the same time. No one can. Not even you, Dr. House.

[Cut to a hallway. Wilson meets up with House.]

Wilson: How’d it go?

House: She has God inside her. It would have been easier to deal with a tumor.

Wilson: Maybe she’s allergic to God.

[Cut to House walking down the hall with the ducklings in tow.]

House: We looked everywhere for an allergen that could be causing this reaction except one place: inside her.

Foreman: On her medical history she didn’t mention any surgery.

House: She had one.

Cameron: Can we get her records? What hospital was it at?

House: She didn’t have it at a hospital. Order a full body scan.

Chase: What if she refuses?

House: Tell her I’m looking for a miracle.

[Cut to the imaging center.]

Foreman: No piercings, no fillings, no surgical pins in the arm, no implants…

Chase: It’s clean as a whistle. What’s House looking for? [Foreman shakes his head, and then squints at the screen.]

Foreman: What is that?

Chase: Don’t know.

Foreman: Lock on it. Get a 3D representation. [The image shows a piece of metal in the form of a cross.]

Cameron: Oh my God!

[Cut to House, looking at the xrays.]

House: The copper cross, a form of birth control pulled off the market in the 80s.

Foreman: So, she’s allergic to copper.

House: Rare, but it happens.

Chase: Wouldn’t she know she had an IUD?

House: She had an abortion. IUD must have been left in, embedded in the endometrial tissue where it couldn’t be detected.

Chase: So, all we have to do is remove the IUD –

[Cut to Chase talking to Augustine]

Chase: -and the symptoms should subside.

Augustine: I got this IUD when I was fifteen. It’s been more than twenty years.

Chase: Prolonged exposure to an allergen with minimal symptoms. But at some point, all it takes is one last contact to cause a full-blown reaction. It’s like a balloon filled with air. One last breath, it explodes.

Augustine: The first time I got the rash was when I was washing the copper cookware.

Chase: And all your subsequent symptoms came from ingesting food prepared in it.

Augustine: Dr. House found his miracle.

Chase: I doubt he’ll interpret it that way.

Augustine: You told me your favorite passage. Would you like to hear mine? [Chase nods]. “Celebrate and be glad, for your brother was dead and is alive again.”

Chase: The prodigal son.

Augustine: He’ll be waiting for you when you’re ready.

Chase: We’ll schedule your surgery for tomorrow.

[Cut to the clinic desk. House is again throwing candies. Wilson enters and sits next to him, giving him coffee.]

Wilson: The sixth circle of Hell.

House: Confined in a sweat box with a bloody nose and all the tissues are soggy.

Wilson: I think that’s the seventh.

House: Nope, seventh is–

Wilson: God, we must be fun at parties.

House: I think we both know the flaw in that theory.

Wilson: How’s the Sister?

House: Kidneys functioning, heart rate is normal. You know how it is with nuns: you take out their IUDs and they bounce right back.

Wilson: Great.

House: Told you I didn’t screw up.

Wilson: You screwed up.

House: I gave her 0.1 cc of epinephrine.

Wilson: Yeah, and if Cuddy hadn’t taken you off the case, you would have killed her. [small pause] You want to come over for Christmas dinner?

House: You’re Jewish.

Wilson: Yeah, Hanukkah dinner. What do you care? It’s food, it’s people.

House: No thanks.

Wilson: Maybe I’ll come to your place.

House: Your wife doesn’t mind being alone at Christmas?

Wilson: I’m a doctor, she’s used to being alone. [House raises his eyebrows.] I don’t want to talk about it.

House: [quickly] Neither do I. [Cuddy enters.]

Cuddy: You did good with the nun. Congratulations.

House: Thank you.

Cuddy: Merry Christmas, Dr. House. Dr. Wilson. [She leaves.]

Wilson: Good night. That was sweet.

[End montage. “Silent Night” is being played on the piano. Starts with House and Wilson, sitting in House’s place eating Chinese food, talking and laughing. Cuts to the hospital Christmas party for the sick kids. Foreman is dressed up as Santa. Cuts to House, now alone, playing the piano. Cuts to Cameron, in her office with a Christmas present. Snow is falling in the background. Cuts to Cuddy, who is tending a patient. Back to House on the piano. Cuts to the hospital Chapel service. The four nuns we’ve met are present. Chase is watching through the windows. Final shot of House at the piano.]


END